IAN WILKINSON LAC (NPI# 1053857482) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053857482 |
| Entity Type | Organization |
| Organization Name | IAN WILKINSON LAC |
| Practice Address |
4829 Ne Martin Luther King Blvd Suite 101 Portland OR 97211-3491 |
| Mailing Address |
342 Ne Morgan St Portland OR 97211-2934 |
| Practice Telephone | 5417061888 |
| Mailing Telephone | 5417061888 |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |
| Authorized Official Name | IAN JAMES WILKINSON (ACUPUNCTURIST) |
| Authorized Official Telephone | 5417061888 |
| Authorized Official Credential | LAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | AC179984 | OR | Managed Care Organizations |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | IAN WILKINSON LAC | 64718 Starwood Drive, Bend, OR 97703 |
| Street Address |
4829 NE MARTIN LUTHER KING BLVD SUITE 101 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97211-3491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801879614 | Shawn Vindel Dailey | Physical Therapist | 4829 Ne Martin Luther King Blvd, Ste 101, Portland, OR 97211-3351 | 2005-11-25 |
| 1649250796 | David Allen Deppeler | Physical Therapist | 4829 Ne Martin Luther King Blvd, Ste 101, Portland, OR 97211-3351 | 2006-01-17 |
| 1275519662 | Therapeutic Associates Inc | Physical Therapist | 4829 Ne Martin Luther King Blvd, Suite 101, Portland, OR 97211-3351 | 2005-12-19 |
| 1861475675 | David Vance Mchenry | Physical Therapist | 4829 Ne Martin Luther King Blvd, Ste 101, Portland, OR 97211-3351 | 2005-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386104586 | Rachel Joy Kendall | Counselor | 5257 Nw Martin Luther King Jr. Blvd, 202e, Portland, OR 97211 | 2019-03-22 |
| 1073014601 | Kelli Minton | Behavior Technician | 7035 Ne 9th Ave, Portland, OR 97211 | 2018-02-28 |
| 1083145726 | Warren H Baumann | Registered Nurse | 854 Ne Simpson St, Portland, OR 97211 | 2017-03-24 |
| 1407277411 | Regina Barnett | Case Manager/Care Coordinator | 509 Ne Alberta St., Portland, OR 97211 | 2013-12-17 |
| 1578905964 | Carmel Therese Irving | Social Worker | 5912 Ne 16th Ave, Portland, OR 97211 | 2013-07-25 |
| 1629310990 | Lisa Peacock | Counselor | 4433 Ne 35 Place, Portland, OR 97211 | 2013-03-25 |
| 1285907915 | Michele Karen Koder | Pharmacist | 3529 Ne Martin Luther King, Jr. Blvd., Portland, OR 97211 | 2012-02-10 |
| 1629368196 | Alexis Miranda Barker | Massage Therapist | 4929 Ne 30th Ave, Zen Space Healing, Portland, OR 97211 | 2011-04-18 |
| 1396041760 | Kara Ann Fuerst | Specialist | 3325 Ne Prescott, Portland, OR 97211 | 2011-02-02 |
| 1063746337 | Laura K Elvers | Pharmacist | 6116 Ne Mlk, Portland, OR 97211 | 2009-09-18 |
| Find all providers in zip 97211 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215387402 | Fabiana Garcia | Preferred Provider Organization | 18139 Ne Couch St, Portland, OR 97230-7281 | 2016-06-17 |
| 1730538273 | Paula Lowden | Preferred Provider Organization | 1023 Se Lambert St, Portland, OR 97202-6329 | 2016-06-06 |
| 1225445166 | Northwest Acupuncture | Preferred Provider Organization | 10224 Sw Park Way # A, Portland, OR 97225-5010 | 2014-07-11 |
| 1770905879 | Willamette Dental | Preferred Provider Organization | 17804 Nw Marylhurst Dr, Portland, OR 97229-7913 | 2014-01-09 |
| 1366882318 | Radu Pescarus | Preferred Provider Organization | 408 Nw 12th Ave Apt 304, Portland, OR 97209-2945 | 2013-07-04 |
| 1679703458 | Intercultual Psychiatric Progam | Preferred Provider Organization | 3633 Se 35th Place, Portland, OR 97202 | 2009-07-15 |
| 1811940422 | Healthcare Resources Northwest Inc | Preferred Provider Organization | 305 Ne 102nd Ave, Suite 250, Portland, OR 97220-4161 | 2006-05-18 |
| 1356348106 | Cascade 205 Orthopedic and Sports Physical Therapy, PC | Preferred Provider Organization | 9260 Se Stark St, Suite B, Portland, OR 97216-1640 | 2005-07-07 |
| 1194195453 | Makai Massage & Spa, LLC | Preferred Provider Organization | 3758 Se Milwaukie Ave, Portland, OR 97202-3805 | 2015-09-30 |
| 1679942007 | Makai Massage & Spa | Preferred Provider Organization | 3758 Se Milwaukie Ave, Portland, OR 97202-3805 | 2015-09-16 |
| 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.