NORTHWEST PRIMARY CARE GROUP PC (NPI# 1043230972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043230972 |
| Entity Type | Organization |
| Organization Name | NORTHWEST PRIMARY CARE GROUP PC |
| Practice Address |
16144 Se Happy Valley Town Center Dr Ste 101 Happy Valley OR 97086-4257 |
| Mailing Address |
Po Box 22075 Milwaukie OR 97269-2075 |
| Practice Telephone | 5036594988 |
| Practice Fax Number | 5036984018 |
| Mailing Telephone | 5036594777 |
| Mailing Fax Number | 5036525223 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-06-03 |
| Authorized Official Name | MR. MICHAEL WHITBECK (ADMINISTRATOR) |
| Authorized Official Telephone | 5036594777 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500620284 | 05 | |
| OR | RAILROAD GROUP PTAN | CE8055 | 01 |
| OR | CLIA | 38D0888269 | 01 |
| OR | 226666 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144319658 | Northwest Primary Care Group PC | Nurse Practitioner | 6327 Se Milwaukie Ave, Portland, OR 97202-5418 | 2006-10-12 |
| 1083638589 | Northwest Primary Care Group PC | Family Medicine | 10024 Se 32nd Ave, Milwaukie, OR 97222-6514 | 2006-07-27 |
| 1023032372 | Northwest Primary Care Group PC | Durable Medical Equipment & Medical Supplies | 16144 Se Happy Valley Town Center Dr Ste 101, Happy Valley, OR 97086-4257 | 2006-07-27 |
| 1922028869 | Northwest Primary Care Group PC | Occupational Therapist | 12119 Se Stevens Ct, Portland, OR 97266-8620 | 2006-07-21 |
| 1801856737 | Northwest Primary Care Group PC | Nurse Practitioner | 3033 Se Monroe St, Milwaukie, OR 97222-6636 | 2006-03-24 |
| Street Address |
16144 SE HAPPY VALLEY TOWN CENTER DR STE 101 |
| City | HAPPY VALLEY |
| State | OR |
| Zip Code | 97086-4257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023032372 | Northwest Primary Care Group PC | Durable Medical Equipment & Medical Supplies | 16144 Se Happy Valley Town Center Dr Ste 101, Happy Valley, OR 97086-4257 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063803674 | Brandy Lynn Sajovic | Case Manager/Care Coordinator | 10822 Se 82nd Ave., Suite K, Happy Valley, OR 97086 | 2015-02-18 |
| 1851795561 | Tyler Lundquist | Chiropractor | 16144 Se Happy Valley Town Center Dr #214, Happy Valley, OR 97086 | 2014-10-09 |
| 1184040644 | Rui O'reilly | Massage Therapist | 10911 Se Alyssa Dr, Happy Valley, OR 97086 | 2014-03-07 |
| 1083036990 | Laura Dillard | Registered Nurse | 10822 Se 82nd Ave, Happy Valley, OR 97086 | 2014-01-11 |
| 1699027672 | Clackamas Town Dental, LLC | Dentist | 9225 Se Sunnyside Road, Clackamas, OR 97086 | 2012-10-15 |
| 1750639233 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 11800 Se 82nd Avenue, Happy Valley, OR 97086 | 2012-08-15 |
| 1962641654 | Mt Scott Vision and Ocular Imaging Center PC | Optometrist | 9300 Ne 91st Ave, Suite 100, Happy Valley, OR 97086 | 2009-02-19 |
| 1598916546 | Cynthia Sue Weaver | Nurse Practitioner | 9300 Se 91 Ave., Suite 400, Portland, OR 97086 | 2008-10-08 |
| 1396928776 | Cary Ann Fardal | Dietitian, Registered | 13444 Se Piper Dr, Happy Valley, OR 97086 | 2007-12-09 |
| 1689873242 | New Seasons Market - Happy Valley | Pharmacy | 15861 Se Happy Valley Town Center Dr., Happy Valley, OR 97086 | 2007-07-13 |
| Find all providers in zip 97086 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255678439 | Daniel Alexander Ananyev | Family Medicine | 16180 Se Sunnyside Rd Ste 102, Happy Valley, OR 97015-6302 | 2013-01-09 |
| 1568625945 | Larry Lyman Tibbles | Family Medicine | 8601 Se 141st Ct, Happy Valley, OR 97086-5648 | 2008-07-07 |
| 1790777480 | Valley View Medical Clinic PC | Family Medicine | 14785 Se Oregon Trail Dr, Happy Valley, OR 97015-6446 | 2005-08-18 |
| 1316460876 | Sunrise Corporate Services, LLC | Family Medicine | 9300 Se 91st Ave Ste 201, Happy Valley, OR 97086-3762 | 2017-07-17 |
| 1134539851 | Alan Craig Thom | Family Medicine | 9200 Se 91st Ave Ste 220, Happy Valley, OR 97086-3756 | 2014-05-02 |
| 1053627331 | Paula M Crone, Do PC | Family Medicine | 9200 Se 91st Ave Ste 220, Happy Valley, OR 97086-3756 | 2010-08-25 |
| 1437460193 | Tetyana O Odarich | Family Medicine | 9300 Se 91st Ave Ste 201, Happy Valley, OR 97086-3762 | 2010-06-28 |
| 1932344199 | Christine Gray | Family Medicine | 16180 Se Sunnyside Rd, Suite 102, Happy Valley, OR 97015-6301 | 2008-12-02 |
| 1508055781 | Creekside Family Practice, LLC | Family Medicine | 9200 Se 91st Ave, Suite #220, Happy Valley, OR 97086-3756 | 2007-10-23 |
| 1346466323 | Brenda Diane Roberts | Family Medicine | 16180 Se Sunnyside Rd, Ste 102, Happy Valley, OR 97015-6301 | 2007-04-18 |
| Find all providers in HAPPY VALLEY | ||||
| City | HAPPY VALLEY |
| Zip Code | 97086 |
Please comment or provide details below to improve the information on NORTHWEST PRIMARY CARE GROUP PC.
| 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.