DR. SONIA BYNUM (NPI# 1154518504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154518504 |
| Entity Type | Individual |
| Full Name | DR. SONIA BYNUM |
| Credential | M.D. |
| Practice Address |
1547 Ne 40th Ave Ste B Portland OR 97232-1862 |
| Mailing Address |
1840 E Ray Rd Chandler AZ 85225-8720 |
| Practice Telephone | 5032841937 |
| Practice Fax Number | 5032843908 |
| Mailing Telephone | 8553970197 |
| Mailing Fax Number | 8002726512 |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2019-11-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
MD60647352 | WA | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
MD161126 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500652596 | 05 | |
| WA | 2081762 | 05 |
| Street Address |
1547 NE 40TH AVE STE B |
| City | PORTLAND |
| State | OR |
| Zip Code | 97232-1862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972505584 | Robert Provenzano | Internal Medicine | 1547 Ne 40th Ave Ste B, Portland, OR 97232-1862 | 2005-08-12 |
| 1215308200 | Sushil S Deshmukh | Internal Medicine | 1547 Ne 40th Ave Ste B, Portland, OR 97232 | 2015-10-15 |
| 1477973204 | Stacy Landers | Physician Assistant | 1547 Ne 40th Ave Ste B, Portland, OR 97232-1862 | 2014-04-19 |
| 1679903231 | Pacific Kidney & Hypertension, LLC | Internal Medicine | 1547 Ne 40th Ave Ste B, Portland, OR 97232-1862 | 2013-11-19 |
| 1063791291 | Cecille Marie Cueto Sales | Internal Medicine | 1547 Ne 40th Ave Ste B, Portland, OR 97232-1862 | 2011-08-05 |
| 1023190469 | Supriya Khan | Internal Medicine | 1547 Ne 40th Ave Ste B, Portland, OR 97232-1862 | 2006-10-19 |
| 1467439547 | Sallie E Israelit | Internal Medicine | 1547 Ne 40th Ave Ste B, Portland, OR 97232-1862 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293215 | Oregon Change Clinic | Clinic/Center | 650 Ne Holladay Street, Suite 1600, Portland, OR 97232 | 2020-10-17 |
| 1154969947 | Lori Kristen Miracle | Acupuncturist | Kwan Yin Healing Arts Center East Inc, 3115 Ne Sandy Blvd. Suite 231, Portland, OR 97232 | 2019-12-12 |
| 1194285411 | Onampai Modina Soondarotok | Student in an Organized Health Care Education/Training Program | Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 | 2019-03-22 |
| 1003399635 | Cathleen Nicole Wenberg | Social Worker | 1839 Ne Couch St, Portland, OR 97232 | 2018-09-10 |
| 1508350760 | Float North | Acupuncturist | 1617 Ne 17th Ave., Portland, OR 97232 | 2018-06-20 |
| 1629560719 | Rachael Lee Walters | Doula | 3005 Ne Hoyt St, Portland, OR 97232 | 2018-06-04 |
| 1225529431 | Jason Sutherland | Social Worker | 707 Ne Couch, Portland, OR 97232 | 2018-05-23 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1639680374 | Amanda Matteo | Counselor | 20 Ne 10th Ave, Portland, OR 97232 | 2017-10-20 |
| Find all providers in zip 97232 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1184133746 | Abd Assalam Qannus | Internal Medicine | 22 Bramhall St Rm 5219, Portland, ME 04102-3134 | 2017-09-27 |
| 1023403748 | Sarah Gilligan | Internal Medicine | 19 Capisic St, Portland, ME 04102-2203 | 2015-03-31 |
| 1528487527 | Janie Luong | Internal Medicine | 10201 Se Main St Ste 27, Portland, OR 97216-2937 | 2014-04-08 |
| 1386074953 | David Alan Mccarron | Internal Medicine | 120 Nw 9th Ave, Suite 206, Portland, OR 97209-3324 | 2013-11-19 |
| 1578859849 | Thuy Xuan Le | Internal Medicine | 1040 Nw 22nd Ave Ste 480, Portland, OR 97210-3062 | 2011-06-24 |
| 1427348150 | Mark Nguyen | Internal Medicine | 1130 Nw 22nd Ave Ste 640, Portland, OR 97210-2993 | 2011-04-14 |
| 1720377039 | Robert Whitney Rope | Internal Medicine | 3181 Sw Sam Jackson Park Rd Mc Sjh6, Portland, OR 97239-3011 | 2011-04-07 |
| 1578707451 | Kate Schoolwerth Gustafson | Internal Medicine | 3710 Sw Us Veterans Hospital Rd # P3neph, Portland, OR 97239-2964 | 2009-04-23 |
| 1174777973 | Tricia Noelle Jesperson | Internal Medicine | 5050 Ne Hoyt St Ste B54, Portland, OR 97213 | 2008-11-06 |
| 1861677825 | Apolonia G. Silva | Internal Medicine | 6736 Ne Killingsworth Street La Clinica De Buena Salud, Portland, OR 97218-3338 | 2008-01-08 |
| 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.