THERESA MCDERMOTT (NPI# 1033584487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033584487 |
| Entity Type | Individual |
| Full Name | THERESA MCDERMOTT |
| Practice Address |
2020 Nomad Ct Se Salem OR 97306-9540 |
| Practice Telephone | 5035811040 |
| Practice Fax Number | 5035850491 |
| Mailing Telephone | 5035811040 |
| Mailing Fax Number | 5035850491 |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2015-12-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | OR | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477671436 | Theresa A Mcdermott | Chiropractor | 19300 Sw Boones Ferry Rd, Ste D, Tualatin, OR 97062-9086 | 2007-03-27 |
| Street Address |
2020 NOMAD CT SE |
| City | SALEM |
| State | OR |
| Zip Code | 97306-9540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134609050 | Andrea P Merryman | Dental Assistant | 5135 Skyline Rd South, Salem, OR 97306 | 2018-08-20 |
| 1215470315 | Anthony Quoc Ngo | Nurse Practitioner | 5050 Skyline Village Loop, Salem, OR 97306 | 2016-11-22 |
| 1134521305 | Wendy Poling | Occupational Therapy Assistant | 1966 Madras St Se Apt 1082, Salem, OR 97306 | 2014-09-19 |
| 1659601045 | Monarch Medical Group LLC | Clinic/Center | 5686 Commercial St Se, Suite 100, Salem, OR 97306 | 2010-01-06 |
| 1316188006 | Judith A Mitchell | Physician Assistant | 4999 Skyline Rd. S., Salem, OR 97306 | 2009-03-10 |
| 1164685574 | Leon Chira | Pharmacist | 2431 Concomly Rd S, Salem, OR 97306 | 2008-07-07 |
| 1912175035 | Salem Clinic, PC | General Practice | 2531 Boone Road Se, Salem, OR 97306 | 2008-02-11 |
| 1326257486 | Robert Allen Long | Physical Therapist | 6250 Commercial St N.e., Salem, OR 97306 | 2007-05-22 |
| 1922137504 | Charlene Garbutt | Dental Assistant | 5135 Skyline Rd. S., Salem, OR 97306 | 2007-03-02 |
| 1417085747 | Michelle West | Dental Assistant | 5135 Skyline R S, Salem, OR 97306 | 2007-02-28 |
| Find all providers in zip 97306 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528677820 | Charice Monette | Peer Specialist | 4151 Kacey Cir Ne, Salem, OR 97305-4504 | 2020-07-23 |
| 1821649336 | Christopher Adam Handy | Peer Specialist | 3050 Park Ave Ne, Salem, OR 97301-8615 | 2019-09-25 |
| 1922505767 | Amy Nicole Cozad | Peer Specialist | 4275 Commercial St Se Ste 180, Salem, OR 97302-4087 | 2018-04-09 |
| 1649785817 | Keileigh Joy Dull | Peer Specialist | 3213 Center St Ne, Salem, OR 97301-4666 | 2017-12-08 |
| 1104331370 | Christina E Higgins Korkow | Peer Specialist | 2555 Silverton Rd Ne, Salem, OR 97301-0837 | 2017-12-08 |
| 1437682044 | Debra Janae Rice | Peer Specialist | 2555 Silverton Rd Ne Ste C, Salem, OR 97301-0837 | 2017-04-10 |
| 1952834194 | Brian Smith | Peer Specialist | 769 Hawthorne Ave Ne, Salem, OR 97301-4623 | 2017-04-05 |
| 1588013577 | Sarah Harris | Peer Specialist | 4255 32nd Pl Ne, Salem, OR 97301-6735 | 2016-06-09 |
| 1194187476 | Tammi Paul | Peer Specialist | 1300 Broadway St Ne Ste 403, Salem, OR 97301-1420 | 2016-03-24 |
| 1710343926 | Teresa Anne Sims | Peer Specialist | 1599 State Street Ne, Salem, OR 97301 | 2016-01-05 |
| Find all providers in SALEM | ||||
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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.