ANDREA GOUGH-GOLDMAN (NPI# 1013273861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013273861 |
| Entity Type | Individual |
| Full Name | ANDREA GOUGH-GOLDMAN |
| Credential | MD |
| Practice Address |
1030 Ne Couch St Portland OR 97232-3067 |
| Mailing Address |
1027 E Burnside St Portland OR 97214-1328 |
| Practice Telephone | 5032398400 |
| Mailing Telephone | 5032398400 |
| Mailing Fax Number | 5032398407 |
| Enumeration Date | 2012-04-05 |
| Last Update Date | 2019-07-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
MD172073 | OR | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1700 Ne 102nd Ave, Portland, OR 972203804 | 5038132000 |
| Street Address |
1030 NE COUCH ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97232-3067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558482190 | Tara R Vandehey | Counselor | 1030 Ne Couch St, Portland, OR 97232-3067 | 2007-04-02 |
| 1093270779 | Dragosh Negrea | Counselor | 1030 Ne Couch St, Portland, OR 97232-3067 | 2019-02-06 |
| 1326528217 | Zoie Meyers | Counselor | 1030 Ne Couch St, Portland, OR 97232-3067 | 2018-08-20 |
| 1295220879 | Patricia Jane Thompson | Counselor | 1030 Ne Couch St, Portland, OR 97232-3067 | 2018-06-26 |
| 1962993873 | Anthony Traver | Counselor | 1030 Ne Couch St, Portland, OR 97232-3067 | 2018-05-25 |
| 1174023923 | Laura Beatriz Lopez-aybar | Counselor | 1030 Ne Couch St, Portland, OR 97232-3067 | 2018-02-19 |
| 1841715380 | Jeannie Ragatz | Counselor | 1030 Ne Couch St, Portland, OR 97232-3067 | 2017-08-05 |
| 1134658016 | Jaime Abel | Counselor | 1030 Ne Couch St, Portland, OR 97232-3067 | 2017-06-05 |
| 1831623198 | Michelle Barnett | Counselor | 1030 Ne Couch St, Portland, OR 97232-3067 | 2017-04-13 |
| 1689107302 | Emily Sano | Counselor | 1030 Ne Couch St, Portland, OR 97232-3067 | 2017-04-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
| 1154969947 | Lori Kristen Miracle | Acupuncturist | Kwan Yin Healing Arts Center East Inc, 3115 Ne Sandy Blvd. Suite 231, Portland, OR 97232 | 2019-12-12 |
| 1194285411 | Onampai Modina Soondarotok | Student in an Organized Health Care Education/Training Program | Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 | 2019-03-22 |
| 1003399635 | Cathleen Nicole Wenberg | Social Worker | 1839 Ne Couch St, Portland, OR 97232 | 2018-09-10 |
| 1508350760 | Float North | Acupuncturist | 1617 Ne 17th Ave., Portland, OR 97232 | 2018-06-20 |
| 1629560719 | Rachael Lee Walters | Doula | 3005 Ne Hoyt St, Portland, OR 97232 | 2018-06-04 |
| 1225529431 | Jason Sutherland | Social Worker | 707 Ne Couch, Portland, OR 97232 | 2018-05-23 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1639680374 | Amanda Matteo | Counselor | 20 Ne 10th Ave, Portland, OR 97232 | 2017-10-20 |
| Find all providers in zip 97232 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649838590 | Boulder Care Provider Group Pa | Family Medicine | 208 Sw Harvey Milk St Ste 200, Portland, OR 97204-2611 | 2019-06-04 |
| 1417333535 | Ascension Health Centers | Family Medicine | 8083 Se 13th Ave, Suite #3, Portland, OR 97202-6668 | 2015-07-31 |
| 1316006166 | Stephen Cameron | Family Medicine | 3449 N Anchor St, Suite 300a, Portland, OR 97217-7679 | 2006-12-07 |
| 1619538782 | Gabrielle Alyson Bowker | Family Medicine | 17 Bishop St, Portland, ME 04103-2659 | 2019-06-27 |
| 1558719450 | Ascension Medical Group LLC | Family Medicine | 700 N Hayden Island Dr Ste 100, Portland, OR 97217-8130 | 2016-06-01 |
| 1073978284 | Robbie Bahl, Md LLC | Family Medicine | 3769 Se Milwaukie Ave, Portland, OR 97202-3804 | 2015-12-15 |
| 1144648312 | Bradley Michael Buchheit | Family Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2014-04-03 |
| 1942522388 | John Henry Hardy Jr. | Family Medicine | 700 N Hayden Island Dr Ste 100, Portland, OR 97217-8130 | 2010-02-26 |
| 1942469762 | Robbie Bahl | Family Medicine | 3769 Se Milwaukie Ave, Portland, OR 97202-3804 | 2008-06-06 |
| 1033232996 | Jeffrey Benton Hayes | Family Medicine | 1027 E Burnside St, Portland, OR 97214-1328 | 2007-04-07 |
| Find all providers in PORTLAND | ||||
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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.