DR. WALTER PETER ROBERTSON IV (NPI# 1013071042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013071042 |
| Entity Type | Individual |
| Full Name | DR. WALTER PETER ROBERTSON IV |
| Credential | M.D. |
| Practice Address |
10180 Se Sunnyside Rd Kaiser Sunnyside Medical Office Clackamas OR 97015-8970 |
| Practice Telephone | 5036522880 |
| Mailing Telephone | 5036522880 |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2007-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD25037 | OR | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD00047985 | WA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639250137 | Walter F. Robertson | Chiropractor | 1 Canyon Drive, Kayenta, AZ 86033 | 2006-10-18 |
| Street Address |
10180 SE SUNNYSIDE RD KAISER SUNNYSIDE MEDICAL OFFICE |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-8970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407855786 | Kevin C La Cour | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2005-07-19 |
| 1588270466 | Jacob Aaron Stutheit | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-09-16 |
| 1023633005 | Jeremy Ward | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-06-15 |
| 1336761998 | Maksim Ivan Yablonsky | Technician, Other | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-05-17 |
| 1497389811 | Clifford Andrew Moore | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-25 |
| 1417580622 | Taryn Dee | Surgery | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-16 |
| 1881225241 | Jocelyn Mason | Pharmacist | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-02-03 |
| 1760022461 | Katie Keim | Social Worker | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-01-09 |
| 1346887668 | Hannah N. Schroeder | Registered Nurse | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-12-05 |
| 1164072286 | Thien-huong Theresa Van | Student in an Organized Health Care Education/Training Program | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-09-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
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| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457566507 | Ali Reza Faheeh | Internal Medicine | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2007-05-11 |
| 1023236783 | Daniel Philip Lavery | Internal Medicine | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2007-04-20 |
| 1679693881 | Jianyi Wu | Internal Medicine | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2007-03-30 |
| 1144397670 | Beth Lynne Karolle | Internal Medicine | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-11-29 |
| 1225119639 | Shaun Anthony Hedmann | Internal Medicine | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-10-19 |
| 1609969344 | Alan Richard Rosenfeld | Internal Medicine | 10180 Se Sunnyside Rd, Clackamas, OR 97015-9764 | 2006-10-02 |
| 1629175294 | Richard Strauss | Internal Medicine | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-09-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982969820 | Samaritan Pacific Health Services, Inc. | Internal Medicine | 1010 Sw Coast Hwy Ste 101, Newport, OR 97365-5239 | 2012-07-06 |
| 1922362243 | Albany General Hospital | Internal Medicine | 631 Elm St Sw Ste 201, Albany, OR 97321-1952 | 2012-07-02 |
| 1962769679 | Hiro Kawata | Internal Medicine | 3311 Rierbend Dr., Springfield, OR 97477 | 2012-04-19 |
| 1225309685 | Patrick Bergin | Internal Medicine | 1794 Sweetbriar Ln, Eugene, OR 97405-4457 | 2012-01-17 |
| 1154646610 | Theodore Allen Foster IIi | Internal Medicine | 1003 Providence Dr Ste 325, Newberg, OR 97132-7521 | 2010-03-28 |
| 1164755534 | Richard E. Romm M.d., LLC | Internal Medicine | 2082 Dogwood Dr, Eugene, OR 97405-7007 | 2009-09-16 |
| 1568699932 | Arjun K. Chagarlamudi | Internal Medicine | 777 Commercial St. Se, Suite 130, Salem, OR 97301 | 2009-06-12 |
| 1518103274 | Centennial Medical Group Inc. | Internal Medicine | 201 Nw Medical Loop Ste 190, Roseburg, OR 97471-8835 | 2008-12-31 |
| 1124281423 | Jane Tuyet Luu | Internal Medicine | 2222 Nw Lovejoy St Ste 606, Portland, OR 97210-5104 | 2008-07-07 |
| 1811192792 | Med Info Services, LLC | Internal Medicine | 348 S Pine St, Carlton, OR 97111-1228 | 2007-06-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.