PROVIDENCE HEALTH & SERVICES - OREGON (NPI# 1114085545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114085545 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HEALTH & SERVICES - OREGON |
| Other Organization Name | PMG NEWBERG SPECIALTY MEDICINE |
| Practice Address |
1314 E Sherman St Newberg OR 97132-1842 |
| Mailing Address |
Po Box 4949 Portland OR 97208-4949 |
| Practice Telephone | 5035371623 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2010-04-16 |
| Authorized Official Name | MITCHELL NEYHART (CHIEF FINANCE OFFICER) |
| Authorized Official Telephone | 5035749840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 271006 | 05 |
| Other Name | Type Code |
|---|---|
| PMG NEWBERG SPECIALTY MEDICINE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922481456 | Providence Health & Services - Oregon | Psychiatry & Neurology | 10830 Highway 62, Eagle Point, OR 97524-9516 | 2015-07-01 |
| 1023440435 | Providence Health & Services - Oregon | General Acute Care Hospital | 11445 Se Moon Dust Ct, Happy Valley, OR 97086-8033 | 2013-08-08 |
| 1568793313 | Providence Health & Services - Oregon | Clinic/Center | 17550 Provost St Ste 201, Lake Oswego, OR 97034-5199 | 2010-01-19 |
| 1508015348 | Providence Health & Services - Oregon | Clinic/Center | 16180 Se Sunnyside Road, Suite 102, Happy Valley, OR 97015-6302 | 2008-09-17 |
| 1629146121 | Providence Health & Services - Oregon | Otolaryngology | 310 Villa Rd, Suite 104, Newberg, OR 97132-1886 | 2006-12-01 |
| 1992882500 | Providence Health & Services - Oregon | Clinic/Center | 205 N Phoenix Rd, Suite A, Phoenix, OR 97535-9104 | 2006-11-01 |
| 1013018175 | Providence Health & Services - Oregon | Clinic/Center | 510 Bridge St, Vernonia, OR 97064-1218 | 2006-09-25 |
| 1447799523 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd Ste 170, Medford, OR 97504-5590 | 2017-02-22 |
| 1063963106 | Providence Health & Services - Oregon | Clinic/Center | 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504-5589 | 2016-10-24 |
| 1235595299 | Providence Health & Services - Oregon | Clinic/Center | 174 1st Ave N, Ilwaco, WA 98624-9137 | 2016-01-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Providence Health & Services - Oregon | 1801 Lind Avenue, Sw, Renton, WA 98057-9016 |
| Oregon Corporations, Companies and Business Names | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw #9016, Renton, WA 98057 |
| System for Award Management (SAM) Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 4400 Ne Halsey St Bldg 2 Ste 690, Portland, OR 97213-1545 |
| Iowa Business Entities | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave. Sw, Renton, WA 98057 |
| Washington State Corporations | PROVIDENCE HEALTH & SERVICES - OREGON | 1801 Lind Ave Sw # 9016, Renton, WA 98057 |
| Street Address |
1314 E SHERMAN ST |
| City | NEWBERG |
| State | OR |
| Zip Code | 97132-1842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692007 | Gabrielle Anastasia Humlie | Dietitian, Registered | 109 W 8th St, Newberg, OR 97132 | 2020-09-03 |
| 1093278111 | Viva Wheaton Psyd LLC | Clinical Neuropsychologist | 603 E. Hancock St, Newberg, OR 97132 | 2019-04-08 |
| 1255847554 | John Nguyen | Physical Therapy Assistant | 1900 E. Fulton St., Newberg, OR 97132 | 2017-12-21 |
| 1154835338 | Breanne Embrey | Pharmacist | 1001 Providence Dr., Newberg, OR 97132 | 2017-11-26 |
| 1174063473 | Patricia Roberts | Hearing Instrument Specialist | 1014 B N Springbrook Rd, Newberg, OR 97132 | 2017-03-06 |
| 1477906048 | Dr. Marsha A. Green, L.L.C. | Community/Behavioral Health | 710c Foothills Dr, Ste 104, Newberg, OR 97132 | 2016-07-19 |
| 1760841308 | George Fox University Physical Therapy Community Clinic | Physical Therapist | 501 Villa Road, Newberg, OR 97132 | 2016-02-10 |
| 1013321389 | Jaecelle Guadiz Galeniece | Family Medicine | 1003 Providence Dr Ste 110, Newberg, OR 97132 | 2014-06-16 |
| 1790116978 | Nancy Stiehler Thurston | Psychologist | 501 N. Villa Rd., Newberg, OR 97132 | 2013-12-12 |
| 1700138856 | Kristen Z. Grbavac O'halloran | Physical Therapist | 1515 Portland Road, Suite 102, Newberg, OR 97132 | 2012-10-12 |
| Find all providers in zip 97132 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124361241 | Kristina Brittany Moon | Internal Medicine | 1001 N Providence Dr Ste 325, Newberg, OR 97132-7485 | 2013-03-27 |
| 1477867604 | Kathleen M Weiss | Internal Medicine | 414 N Meridian St # 6121, Newberg, OR 97132-2697 | 2010-07-29 |
| 1780742114 | Providence Health & Services | Internal Medicine | 1515 Portland Rd, Newberg, OR 97132-1844 | 2006-12-05 |
| 1306950639 | Keith Henry Griffin | Internal Medicine | 33305 Ne Old Parrett Mountain Rd, Newberg, OR 97132-6936 | 2006-08-17 |
| 1124481346 | Eliot D Hill | Internal Medicine | 1001 Providence Dr, Newberg, OR 97132-7485 | 2016-04-04 |
| 1427425818 | Ian Ledford | Internal Medicine | 1001 Providence Dr, Newberg, OR 97132-7485 | 2015-09-01 |
| 1407273543 | Julien Chirouze | Internal Medicine | 1001 Providence Dr, Newberg, OR 97132-7485 | 2014-03-26 |
| 1679817704 | Matthew Christopher Becker | Internal Medicine | 1003 Providence Dr, Suite 110, Newberg, OR 97132-7521 | 2012-11-15 |
| 1689973182 | Nathaniel Mccoy | Internal Medicine | 1003 Providence Dr, Suite 210, Newberg, OR 97132-7521 | 2011-03-23 |
| 1922266709 | Summer R Lam | Internal Medicine | 1003 Providence Dr, Ste 210, Newberg, OR 97132-7521 | 2008-05-28 |
| Find all providers in NEWBERG | ||||
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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.