TOMAS JOHN WILDENBORG (NPI# 1023395282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023395282 |
| Entity Type | Individual |
| Full Name | TOMAS JOHN WILDENBORG |
| Credential | BS |
| Practice Address |
326 Se 76th Ave Portland OR 97215-1468 |
| Mailing Address |
Po Box 8459 Portland OR 97207-8459 |
| Practice Telephone | 5032553198 |
| Practice Fax Number | 5032550359 |
| Mailing Telephone | 5032380769 |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| Street Address |
326 SE 76TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97215-1468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669541058 | Cascadia Behavioral Healthcare Inc | Clinic/Center | 326 Se 76th Ave, Portland, OR 97215-1468 | 2006-11-07 |
| 1124440920 | Heather Ford | Adult Companion | 326 Se 76th Ave, Portland, OR 97215-1468 | 2014-01-13 |
| 1104248236 | Peggy Surfus | Counselor | 326 Se 76th Ave, Portland, OR 97215-1468 | 2014-01-08 |
| 1508103342 | Marta Buechler | Adult Companion | 326 Se 76th Ave, Portland, OR 97215-1468 | 2013-01-14 |
| 1700144144 | James Abel Justice | Adult Companion | 326 Se 76th Ave, Portland, OR 97215-1468 | 2012-04-23 |
| 1376838417 | Lael Stephanie Gordon | Counselor | 326 Se 76th Ave, Portland, OR 97215-1468 | 2011-06-16 |
| 1780982454 | Laroy William Lackey | Adult Companion | 326 Se 76th Ave, Portland, OR 97215-1468 | 2011-03-04 |
| 1497084461 | Nicholas Maier | Adult Companion | 326 Se 76th Ave, Portland, OR 97215-1468 | 2009-12-21 |
| 1346489770 | Dayna Ann Stierley | Counselor | 326 Se 76th Ave, Portland, OR 97215-1468 | 2009-02-09 |
| 1659579753 | Michael Paul Richard | Adult Companion | 326 Se 76th Ave, Portland, OR 97215-1468 | 2007-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952926339 | Lisa Silverman | Counselor | 1835 Se 50th Avenue, Portland, OR 97215 | 2020-06-11 |
| 1003381195 | Darcie Leigh Juarez | Naturopath | 6118 Se Belmont St Ste 407, Portland, OR 97215 | 2018-10-04 |
| 1740710581 | Riley W Protz | Pharmacist | 5544 E Bursnide, Portland, OR 97215 | 2017-06-14 |
| 1114459088 | Genevieve Kathleen Shields | Registered Nurse | 5451 Se Belmont, Suite 100, Portland, OR 97215 | 2017-03-30 |
| 1205282514 | Aiyana Lucas | Social Worker | 4531 Se Belmont St Ste 310b, Portland, OR 97215 | 2016-05-05 |
| 1508223918 | Catherine Ann Chapman | Counselor | 422 Se 79th Street, Suite 202, Portland, OR 97215 | 2016-01-15 |
| 1518338854 | Cody Begdorian | Acupuncturist | 4220 Se Stark, Portland, OR 97215 | 2015-10-13 |
| 1588040653 | Corinne Leblanc | Acupuncturist | 2305 Se 50th Ave., Suite 200, Portland, OR 97215 | 2015-07-30 |
| 1942688544 | Casey Lynne Peters | Occupational Therapist | 6040 Se Belmont S, Portland, OR 97215 | 2015-05-14 |
| 1457743783 | David Alexander Gambill | Counselor | 8041 E Burnside St., Portland, OR 97215 | 2015-02-24 |
| Find all providers in zip 97215 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184271462 | Taylor Salter | Adult Companion | 7018 N Armour St, Portland, OR 97203-6132 | 2019-08-21 |
| 1235785429 | Lonzall Tatum | Adult Companion | 1212 Sw Clay St Apt 409, Portland, OR 97201-7822 | 2019-08-13 |
| 1205303021 | Imani Anderson | Adult Companion | 434 Ne Roselawn St, Portland, OR 97211-3826 | 2018-10-30 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1104364900 | Rosanna Hunnicutt | Adult Companion | 2601 Se 160th Ave, Portland, OR 97236-2092 | 2017-02-01 |
| 1043755028 | Raolat Ajibade IIi | Adult Companion | 847 N.e 19thave, Portland, OR 97232 | 2016-12-29 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1255789731 | Sherri Schroeder | Adult Companion | 847 Ne 19th Ave., Suite100, Portland, OR 97232 | 2016-05-25 |
| 1750740577 | Sheila Amoo | Adult Companion | 236 N Killingworth St. Apt.b104, Portland, OR 97217 | 2016-02-22 |
| 1609241371 | Denise Broom | Adult Companion | 25 Ne Stafford St, Portland, OR 97211-2241 | 2015-12-07 |
| 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.