STATESERV MEDICAL OF OREGON, LLC (NPI# 1013291657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013291657 |
| Entity Type | Organization |
| Organization Name | STATESERV MEDICAL OF OREGON, LLC |
| Other Organization Name | STATESERV MEDICAL LLC |
| Practice Address |
26100 Sw 95th Ave Suite 200 Wilsonville OR 97070 |
| Mailing Address |
1201 S. Alma School Road Suite 4000 Mesa AZ 85210 |
| Practice Telephone | 5037292371 |
| Practice Fax Number | 5035989737 |
| Mailing Telephone | 3362278030 |
| Mailing Fax Number | 3362273288 |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2019-10-21 |
| Authorized Official Name | CHRISTOPHER ROODE (COO) |
| Authorized Official Telephone | 8776337250 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE STATESERV COMPANIES LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BX2000X |
Durable Medical Equipment & Medical Supplies Specialization: Oxygen Equipment & Supplies |
NPC-0003526 | OR | Suppliers |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | OR | Suppliers |
| Other Name | Type Code |
|---|---|
| StateServ Medical LLC | Other Name - Individual/Organization |
| Street Address |
26100 SW 95TH AVE SUITE 200 |
| City | WILSONVILLE |
| State | OR |
| Zip Code | 97070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457995896 | Rosalyn Sharon Mckinney | Technician | 7798 Sw Vlahos Dr, Wilsonville, OR 97070 | 2019-10-29 |
| 1275027393 | Oregon Regeneration Stem Cell Medical Center, LLC | Chiropractor | 29781 Sw Town Center Loop, Wilsonville, OR 97070 | 2018-06-21 |
| 1073050472 | Kirstin Marie Lauritzen | Chiropractor | 25589 Sw Canyon Creek Rd Ste 100, Wilsonville, OR 97070 | 2017-01-23 |
| 1932642220 | Nicole Galasso | Occupational Therapy Assistant | 25117 Sw Parkway Avenue Suite D, Wilsonville, OR 97070 | 2016-11-18 |
| 1508317512 | Justin Langlais | Naturopath | 25195 Sw Parkway Ave Ste 210, Wilsonville, OR 97070 | 2016-10-14 |
| 1518411149 | Stephanie Tran | Optometrist | 29250 Town Center Loop W, Wilsonville, OR 97070 | 2016-08-11 |
| 1346610607 | Rachel Ziegler | Occupational Therapy Assistant | 25117 Sw Parkway Ave Suite D, Willsonville, OR 97070 | 2015-09-30 |
| 1992184238 | Michelle Miranda | Counselor | 30150 Sw Parkway Ave Ste 300, Wilsonville, OR 97070 | 2015-05-19 |
| 1609275007 | Ryan Bridges | Dentist | 30040 Sw Boones Ferry Rd Ste 20, Wilsonville, OR 97070 | 2014-08-21 |
| 1649604018 | Jason Russell James | Physical Therapist | 29174 Sw Town Center Loop W # 202b, Wilsonville, OR 97070 | 2013-08-21 |
| Find all providers in zip 97070 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548405301 | Multi-material Implant, LLC | Durable Medical Equipment & Medical Supplies | 7266 Sw Iron Horse St, Wilsonville, OR 97070-8880 | 2008-12-09 |
| 1528108511 | Maverick Medical LLC | Durable Medical Equipment & Medical Supplies | 28050 Sw Boberg Rd, Wilsonville, OR 97070-7200 | 2007-02-07 |
| 1821107111 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 8235 Southwest Wilsonville Road, Wilsonville Town Center, Wilsonville, OR 97070-7716 | 2006-08-30 |
| 1588686620 | Scooter Store - Portland LLC | Durable Medical Equipment & Medical Supplies | 25589 Sw Canyon Creek Rd, Ste 800, Wilsonville, OR 97070-8897 | 2006-07-25 |
| 1275784001 | Synergy Medical Systems, LLC. | Durable Medical Equipment & Medical Supplies | 28050 Sw Boberg Rd, Wilsonville, OR 97070-7200 | 2008-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959272 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 281 Laclair St Rm 135, Coos Bay, OR 97420-2988 | 2020-10-14 |
| 1730794181 | Wound Pros Oregon | Durable Medical Equipment & Medical Supplies | 10260 Sw Greenburg Road 4th Floor, Portland, OR 97223-5500 | 2020-09-12 |
| 1881209385 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12555 Nw Cornell Rd, Portland, OR 97229-5683 | 2020-09-11 |
| 1902423676 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 Se Court Pl Ste P, Pendleton, OR 97801-3281 | 2020-06-29 |
| 1851914618 | Bellevue Healthcare II Inc | Durable Medical Equipment & Medical Supplies | 61580 American Ln, Bend, OR 97702-9792 | 2020-05-27 |
| 1538799333 | Big Creek Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 1664 N Coast Hwy, Newport, OR 97365 | 2020-01-21 |
| 1184260325 | Pacific O&p LLC | Durable Medical Equipment & Medical Supplies | 1050 Sw 6th Ave Ste 1100, Portland, OR 97204-1153 | 2019-11-22 |
| 1790335073 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 621 W Madrone St Ste P1, Roseburg, OR 97470-3090 | 2019-09-18 |
| 1386294379 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8145 Se 17th Ave, Portland, OR 97202-6718 | 2019-09-12 |
| 1346899721 | Oregon Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 345 Sw Harrison St, Portland, OR 97201-5364 | 2019-09-09 |
| Find all providers with the same taxonomy | ||||
| City | WILSONVILLE |
| Zip Code | 97070 |
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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.