BRIAN JACOB STATER


Address: 9155 Sw Barnes Rd Ste 536, Portland, OR 97225-6785
Phone: 5039358100

BRIAN JACOB STATER (NPI# 1063702835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1063702835
Entity Type Individual
Full Name BRIAN JACOB STATER
Credential M.D.
Practice Address 9155 Sw Barnes Rd Ste 536
Portland
OR 97225-6785
Mailing Address 847 Ne 19th
Suite 300
Portland
OR 97232
Practice Telephone 5039358100
Practice Fax Number 5039358110
Mailing Telephone 5039632801
Mailing Fax Number 5039632825
Enumeration Date 2011-04-14
Last Update Date 2017-08-01
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Y00000X Otolaryngology MD182454 OR Allopathic & Osteopathic Physicians
N 207Y00000X Otolaryngology A143505 CA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
OR 500725530 05
CA RAILROAD MEDICARE P01719264 01

Office Location

Street Address 9155 SW BARNES RD STE 536
City PORTLAND
State OR
Zip Code 97225-6785

Providers in the same location

NPI Name Taxonomy Address Enumeration
1902107675 Jessica L Eggleston Audiologist 9155 Sw Barnes Rd Ste 536, Portland, OR 97225-6785 2010-11-10
1942832985 Ashley Nicole Stewart Hearing Instrument Specialist 9155 Sw Barnes Rd Ste 536, Portland, OR 97225-6785 2020-02-07
1891284600 Elizabeth Justine Ritchie Audiologist 9155 Sw Barnes Rd Ste 536, Portland, OR 97225 2018-05-07
1417496993 Bridget B Gharst Nurse Practitioner 9155 Sw Barnes Rd Ste 536, Portland, OR 97225-6785 2017-02-17
1639629173 Erica Bocchi Physician Assistant 9155 Sw Barnes Rd Ste 536, Portland, OR 97225 2016-10-08
1710393723 Joseph Robert Gullerud Physician Assistant 9155 Sw Barnes Rd Ste 536, Portland, OR 97225-6785 2014-07-10
1891123592 Kyle Ann Markwell Physician Assistant 9155 Sw Barnes Rd Ste 536, Portland, OR 97225-6785 2013-10-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1508425034 Gabrielle Gonzales Behavior Technician 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 2019-06-08
1558844555 Tate Roseberry Behavior Technician 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 2018-09-14
1982186300 Dean Alan Hopkins Registered Nurse 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 2018-09-01
1316449168 Surgery Center At St. Vincent, LLC Clinic/Center 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 2018-03-07
1730606716 Meghan Louise Lacy Pediatrics 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 2017-08-29
1841733433 Tia Pugh Occupational Therapist 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 2016-11-30
1295185585 Stephanie Lynn Hart Nurse Practitioner 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 2016-06-16
1962866244 Bejian Shamloo Chiropractor 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 2016-04-12
1992162630 Robert Joseph Yoder Psychologist 9045 Barnes Rd, Portland, OR 97225 2016-01-26
1316303951 Katie Herold Chiropractor 9315 Sw Morrison St, Portland, OR 97225 2016-01-12
Find all providers in zip 97225

Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1104289933 Ci An Gerald Tay Otolaryngology 3181 Sw Sam Jackson Park Rd, Pv01, Portland, OR 97239 2016-03-30
1922471291 Caitlin Bertelsen Otolaryngology 3303 Sw Bond Ave Ste 15, Portland, OR 97239-4501 2015-11-08
1962708578 John A Lindgren, Md PC Otolaryngology 9155 Sw Barnes Rd Ste 401, Portland, OR 97225-6631 2011-01-28
1558674861 Lucas Rein Rudmik Otolaryngology 3720 Sw Bond Ave Unit 2210, Portland, OR 97239-4577 2010-07-16
1114193448 Ryan Jeffrey Li Otolaryngology 3181 Sw Sam Jackson Park Rd # 01, Portland, OR 97239-3011 2008-05-06
1598968380 Jeremiah Andrew Alt Otolaryngology 3303 Sw Bond Ave # Ch5e, Portland, OR 97239-3098 2007-06-07
1598835688 Portland Ear Nose & Throat Otolaryngology 10535 Ne Glisan, #350, Portland, OR 97220 2006-11-08
1871674374 Suzanne Cleland Zamudio Md PC Otolaryngology 501 N. Graham, #455, Portland, OR 97227 2006-10-18
1689769028 Ericka Francine King Otolaryngology 3181 Sw Sam Jackson Park Rd. Pv-01, Portland, OR 97225 2006-10-03
1295745198 Charles Leo Kaluza Otolaryngology 2816 Se Steele St, Portland, OR 97202-4525 2006-08-09
Find all providers in PORTLAND

Competitor

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City PORTLAND
Zip Code 97225

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Dataset Information

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.

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