WHITNEY BLAIRE FANCHER (NPI# 1053699645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053699645 |
| Entity Type | Individual |
| Full Name | WHITNEY BLAIRE FANCHER |
| Credential | M.D. |
| Practice Address |
831 Nw Council Dr Suite 301 Gresham OR 97030-3721 |
| Mailing Address |
1793 13th St Se Salem OR 97302-2541 |
| Practice Telephone | 5033628385 |
| Practice Fax Number | 5033628435 |
| Mailing Telephone | 5033628385 |
| Mailing Fax Number | 5033628435 |
| Enumeration Date | 2011-07-30 |
| Last Update Date | 2016-11-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | MD60644753 | WA | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | MD177022 | OR | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 63662 | WI | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 125059648 | IL | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD177022 | OR | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
MD60644753 | WA | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
63662 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
831 NW COUNCIL DR SUITE 301 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-3721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992798169 | Timothy L Kelly | Anesthesiology | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2005-08-23 |
| 1821341223 | Columbia Pain and Spine Institute | Clinical Medical Laboratory | 831 Nw Council Dr, #300, Gresham, OR 97030 | 2012-10-23 |
| 1750643060 | John C. Anderson, M.d., P.C. | Orthopaedic Surgery | 831 Nw Council Dr, Suite 130, Gresham, OR 97030-3721 | 2012-06-12 |
| 1386897809 | Maria S Kling | Nurse Practitioner | 831 Nw Council Dr, Suite 101, Gresham, OR 97030-3721 | 2008-10-28 |
| 1932376894 | Sarah Schultz | Internal Medicine | 831 Nw Council Dr, Suite 125, Gresham, OR 97030-3721 | 2008-05-09 |
| 1649442476 | Melanie Marie Falgout | Family Medicine | 831 Nw Council Dr, Suite 125, Gresham, OR 97030-3721 | 2008-04-01 |
| 1639352594 | Rose City Breast Care, LLC | Surgery | 831 Nw Council Dr, Suite 301, Gresham, OR 97030-3721 | 2007-12-13 |
| 1851587364 | Grayden Woodruff King | Podiatrist | 831 Nw Council Dr, Ste 203, Gresham, OR 97030-3721 | 2007-09-18 |
| 1720278633 | Karen Shaw | Nurse Practitioner | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2007-07-26 |
| 1497954994 | Maryellen Hibbard | Nurse Practitioner | 831 Nw Council Dr, Suite 300, Gresham, OR 97030-3721 | 2007-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871574947 | Edgar Maeyens | Dermatology | 375 Park Ave, Suite 5, Coos Bay, OR 97420-2242 | 2005-11-07 |
| 1447713573 | Dermatology Health Specialists, PC | Dermatology | 1693 Sw Chandler Ave Ste 250, Bend, OR 97702-3231 | 2019-04-06 |
| 1972913259 | Lindsey Fix | Dermatology | 1605 G St, Springfield, OR 97477 | 2014-05-07 |
| 1558515494 | Jay Y Park Md, PC | Dermatology | 360 S Garden Way Ste 230, Eugene, OR 97401-8173 | 2008-11-05 |
| 1780846501 | Bend Memorial Clinic PC | Dermatology | 2600 Ne Neff Rd, Bend, OR 97701-6337 | 2008-07-02 |
| 1700081742 | Richard I. Ecker | Dermatology | 706 Ne Evans St, Mcminnville, OR 97128-3926 | 2007-06-19 |
| 1396845814 | Parwathi Vasudeva Paniker | Dermatology | 3600 N Interstate Ave, Portland, OR 97227-1106 | 2006-09-24 |
| 1184643249 | William J Delgado | Dermatology | 2705 Ne Conners Ave, Bend, OR 97701-6904 | 2006-07-19 |
| 1205805405 | Stephen N Snow | Dermatology | 3600 N Interstate Ave, Dermatology/mohs Surg Central Interstate Medical Office, Portland, OR 97227-1106 | 2006-03-17 |
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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.