JASON ROLAND WOLLMUTH (NPI# 1164498499) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164498499 |
Entity Type | Individual |
Full Name | JASON ROLAND WOLLMUTH |
Credential | M.D. |
Practice Address |
1111 Ne 99th Ave Ste 201 Portland OR 97220-9442 |
Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
Practice Telephone | 5039621000 |
Mailing Telephone | 5032156494 |
Enumeration Date | 2006-02-27 |
Last Update Date | 2020-10-06 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD26636 | OR | Allopathic & Osteopathic Physicians |
Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
MD26636 | OR | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 240371 | 05 |
Street Address |
1111 NE 99TH AVE STE 201 |
City | PORTLAND |
State | OR |
Zip Code | 97220-9442 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780285221 | Jessica Anne Dejong | Physician Assistant | 1111 Ne 99th Ave Ste 201, Portland, OR 97220-9442 | 2020-11-02 |
1578008397 | Benjamin J Hartwig | Nurse Practitioner | 1111 Ne 99th Ave Ste 201, Portland, OR 97220-9442 | 2017-01-03 |
1538558242 | Aaron Steuart Cosman | Nurse Practitioner | 1111 Ne 99th Ave Ste 201, Portland, OR 97220-9442 | 2015-01-19 |
1164765111 | Jason Shawn Bensch | Internal Medicine | 1111 Ne 99th Ave Ste 201, Portland, OR 97220-9442 | 2013-03-28 |
1407112535 | Elizabeth A Bearden | Nurse Practitioner | 1111 Ne 99th Ave Ste 201, Portland, OR 97220-9442 | 2012-04-03 |
1386925899 | Alefiyah Rajabali | Internal Medicine | 1111 Ne 99th Ave Ste 201, Portland, OR 97220-9442 | 2011-08-30 |
1760771463 | Paolo Pilar Gabriel | Internal Medicine | 1111 Ne 99th Ave Ste 201, Portland, OR 97220-9442 | 2011-04-04 |
1487748836 | Aaron Ben Schoenkerman | Internal Medicine | 1111 Ne 99th Ave Ste 201, Portland, OR 97220-9442 | 2006-10-02 |
1285741843 | Jill M Gelow | Internal Medicine | 1111 Ne 99th Ave Ste 201, Portland, OR 97220-9442 | 2006-08-23 |
1982610481 | Crispin Henry Davies | Internal Medicine | 1111 Ne 99th Ave Ste 201, Portland, OR 97220-9442 | 2006-08-01 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
Find all providers in zip 97220 |
Taxonomy Code | 207RI0011X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Interventional Cardiology |
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477994101 | Sena Kilic | Internal Medicine | 3181 Sw Sam Jackson Park Rd Fl Uhn622, Portland, OR 97239-3011 | 2013-07-10 |
1598994709 | Harkawal Singh Hundal | Internal Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2009-07-09 |
1295764504 | Greg Christian Larsen | Internal Medicine | 3710 Sw Us Veterans Hospital Rd, Cardiology Section, P-3-card, Portland, OR 97239-2964 | 2006-06-30 |
1366478810 | Arun Kuchela | Internal Medicine | 1040 Nw 22nd Ave, Ste. 660, Portland, OR 97210-3057 | 2006-06-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114425493 | Cardiac Cin of Oregon LLC | Internal Medicine | 1867 Williams Hwy Ste 289, Grants Pass, OR 97527-5854 | 2018-01-31 |
1255455929 | Cameron A. Ramsay | Internal Medicine | 19250 Sw 65th Ave Ste 265, Tualatin, OR 97062-7747 | 2007-03-19 |
1114081700 | George Kubac | Internal Medicine | 2614 Clover St, Klamath Falls, OR 97601-1132 | 2006-12-20 |
1215978671 | Roger J. Dreiling | Internal Medicine | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504-5590 | 2006-06-09 |
1437111507 | Northwest Cardiologists, P.C. | Internal Medicine | 333 Se 7th Ave, Suite 5200, Hillsboro, OR 97123-4157 | 2006-04-04 |
1114923760 | Vincent P Reyes | Internal Medicine | 349 Se 7th Ave, Hillsboro, OR 97123-4112 | 2005-06-27 |
1588126650 | Cor Care of Or, LLC | Internal Medicine | 1867 Williams Hwy Ste 289, Grants Pass, OR 97527-5854 | 2019-04-05 |
1467719641 | Ross Vimr | Internal Medicine | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2012-04-12 |
1932499373 | Deepika Narasimha | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2011-04-18 |
1265745715 | Ashraf Abusara | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2010-07-26 |
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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.