EDGAR ALLAN GUTIERREZ (NPI# 1093053449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093053449 |
Entity Type | Individual |
Full Name | EDGAR ALLAN GUTIERREZ |
Practice Address |
8122 Se Tibbetts St Portland OR 97206-1768 |
Mailing Address |
5750 Se Tranquil Ct Milwaukie OR 97267-4343 |
Practice Telephone | 5032551111 |
Enumeration Date | 2013-01-18 |
Last Update Date | 2015-02-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 163W00000X | Registered Nurse | 200341187-RN | OR | Nursing Service Providers |
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201405804NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588127351 | Edgar Alberto Gutierrez | Student in an Organized Health Care Education/Training Program | 3690 Grandview Pkwy, Birmingham, AL 35243-3326 | 2019-04-09 |
1205318847 | Edgar Gutierrez | Counselor | 518 S Browne St, Spokane, WA 99204-2315 | 2018-08-30 |
1073991766 | Edgar Gutierrez | Counselor | 5965 S 900 E, Murray, UT 84121-1720 | 2015-05-13 |
1083021943 | Edgar Gutierrez | Counselor | 2650 Jones Way Ste 10, Simi Valley, CA 93065-1215 | 2014-07-11 |
Street Address |
8122 SE TIBBETTS ST |
City | PORTLAND |
State | OR |
Zip Code | 97206-1768 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831408053 | Jason Paul Taylor | Physician Assistant | 8122 Se Tibbetts St, Portland, OR 97206-1768 | 2010-10-05 |
1407456551 | Phuong T Phan | Pharmacist | 8122 Se Tibbetts St, Portland, OR 97206-1768 | 2020-10-28 |
1487289989 | Phuong Anh Ngoc Huynh | Pharmacist | 8122 Se Tibbetts St, Portland, OR 97206-1768 | 2020-03-05 |
1457829970 | Jimmy Minh Hoang | Internal Medicine | 8122 Se Tibbetts St, Portland, OR 97206-1768 | 2018-11-02 |
1083103097 | Drew Rhys Haven | Massage Therapist | 8122 Se Tibbetts St, Portland, OR 97206-1768 | 2018-05-04 |
1154829513 | Diana Bui | Family Medicine | 8122 Se Tibbetts St, Portland, OR 97206-1768 | 2018-01-31 |
1538539150 | Emily Sweedler | Massage Therapist | 8122 Se Tibbetts St, Portland, OR 97206-1768 | 2015-09-25 |
1548664816 | Helen Doan | Pharmacist | 8122 Se Tibbetts St, Portland, OR 97206-1768 | 2014-10-15 |
1649682725 | Caleb Alexander Langsam | Physician Assistant | 8122 Se Tibbetts St, Portland, OR 97206-1768 | 2014-05-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346852365 | Amanda Kristine Fredrickson | Dietitian, Registered | 3611 Se 64th Ave., Portland, OR 97206 | 2020-08-20 |
1578108940 | Amy Groulx | Technician | 5506 Se Mitchell St, Portland, OR 97206 | 2019-11-08 |
1477061265 | Lisa Marie Matejka | Naturopath | 5235 Se Lambert St, Apt. #b6, Portland, OR 97206 | 2018-01-16 |
1639625205 | Mollie Kathleen Pence | Registered Nurse | 2415 43rd Ave, Suite 100, Cascadia Behavioral Healthcare Urgent Walkin Clinic, Portland, OR 97206 | 2016-09-01 |
1457709164 | Lauren Murdoch | Massage Therapist | 4629 Southeast Woodstock Boulevard, Portland, OR 97206 | 2016-06-03 |
1962897785 | Meigra Simon LLC | Mechanotherapist | 6842 Se Henry St, Portland, OR 97206 | 2015-03-30 |
1891186508 | Teresa Leckron-myers | Case Manager/Care Coordinator | 7916 Se Foster Rd, Portland, OR 97206 | 2015-02-17 |
1831597590 | Boey Yean Lim | Acupuncturist | 4629 Se Woodstock Blvd, Portland, OR 97206 | 2014-12-12 |
1295082329 | Chase Heywood Price | Acupuncturist | 5425 Se Raymond Street, Portland, OR 97206 | 2012-08-08 |
1154678423 | Annelise Sevastiana Schnase | Counselor | 4311 Se Woodstock Blvd, Portland, OR 97206 | 2012-08-06 |
Find all providers in zip 97206 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1043822794 | Danielle Langer | Nurse Practitioner | 35 Ridgeview Rd, Portland, CT 06480-4014 | 2020-08-23 |
1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
1114566650 | Sadie Garnache-poirier | Nurse Practitioner | 65 W Commercial St Ste 107, Portland, ME 04101-4789 | 2020-01-02 |
1902441629 | Jennifer Marie Colpitts | Nurse Practitioner | 1600 Congress St Ste B, Portland, ME 04102-2148 | 2019-11-18 |
1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
1265081640 | Christina Lee | Nurse Practitioner | 144 State St # 1, Portland, ME 04101-3776 | 2019-09-09 |
1407401474 | Abby Christine Vopal | Nurse Practitioner | 66 Bramhall St Fl 1, Portland, ME 04102-3355 | 2019-08-07 |
1770145294 | Cynthia Marie Martinez | Nurse Practitioner | 1145 Austin St, Portland, TX 78374-2013 | 2019-07-04 |
1528532306 | Matthew James Keelin | Nurse Practitioner | 6801 Ne Cornfoot Rd, Portland, OR 97218-2743 | 2019-01-15 |
1659847580 | Colleen Jeanette Scott | Nurse Practitioner | 650 Nw Irving St, Portland, OR 97209-1272 | 2018-10-18 |
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.