DR. AMANDA ALLAN VANDLAC (NPI# 1225328958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225328958 |
| Entity Type | Individual |
| Full Name | DR. AMANDA ALLAN VANDLAC |
| Credential | M.D. |
| Practice Address |
5050 Ne Hoyt St Suite 514 Portland OR 97213-2991 |
| Mailing Address |
847 Ne 19th Ave Suite 300 Portland OR 97232-2684 |
| Practice Telephone | 5034882323 |
| Practice Fax Number | 5034882340 |
| Mailing Telephone | 5039632801 |
| Mailing Fax Number | 5039632825 |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2016-10-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | MD177691 | OR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500655908 | 05 |
| Street Address |
5050 NE HOYT ST SUITE 514 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-2991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558364570 | Bruce Wilson Dana | Internal Medicine | 5050 Ne Hoyt St, Ste 256, Portland, OR 97213-2982 | 2005-05-23 |
| 1780136242 | Crystal Marie Rodriguez | Physician Assistant | 5050 Ne Hoyt St, Suite 240, Portland, OR 97213-2991 | 2016-11-01 |
| 1558810820 | Janina Browne | Physician Assistant | 5050 Ne Hoyt St, 454, Portland, OR 97213-2991 | 2016-09-28 |
| 1285181974 | Lena Soo Hee Wood | Advanced Practice Midwife | 5050 Ne Hoyt St, Suite 353, Portland, OR 97213-2991 | 2016-09-09 |
| 1780131532 | Hayley M Cusick | Physician Assistant | 5050 Ne Hoyt St, Suite 511, Portland, OR 97213-2991 | 2016-09-08 |
| 1801249164 | Lauren Berman | Speech-Language Pathologist | 5050 Ne Hoyt St, #315, Portland, OR 97213 | 2016-07-21 |
| 1457709123 | Emily C. Nguyen, M.d., P.C. | Specialist | 5050 Ne Hoyt St, Suite 611, Portland, OR 97213-2991 | 2016-06-02 |
| 1356798086 | Bryce Beard | Student in an Organized Health Care Education/Training Program | 5050 Ne Hoyt St, Ste 540, Portland, OR 97213-2991 | 2016-05-23 |
| 1619324340 | Monica Johnson | Student in an Organized Health Care Education/Training Program | 5050 Ne Hoyt St, Ste 540, Portland, OR 97213-2991 | 2016-05-23 |
| 1184071813 | Rahwa Shumet Ghebremichael | Student in an Organized Health Care Education/Training Program | 5050 Ne Hoyt St, Ste 540, Portland, OR 97213-2991 | 2016-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376885418 | Sasha Courand Druskin | Urology | 2226 Nw Pettygrove St, Portland, OR 97210-2608 | 2013-03-26 |
| 1871837468 | Kirit S Shah M.d., P.C. | Urology | 171 Ne 102nd Ave, Portland, OR 97220-4169 | 2012-11-20 |
| 1730484544 | James Bresee | Urology | 9135 Sw Barnes Rd Ste 663, Portland, OR 97225 | 2011-01-26 |
| 1538332291 | James T Pappas, Md, PC | Urology | 5050 Ne Hoyt St Ste 428, Portland, OR 97213-2984 | 2008-04-02 |
| 1679775241 | James Francis Tycast | Urology | 2230 Nw Pettygrove St Ste 210, Portland, OR 97210-2659 | 2007-06-04 |
| 1255546982 | Nicholas A Boncher | Urology | 5050 Ne Hoyt St Ste 210, Portland, OR 97213-2980 | 2007-05-14 |
| 1740329366 | Jaroslava Zoubek | Urology | 800 Sw 13th Ave Ste 663, Portland, OR 97205-1902 | 2007-02-06 |
| 1992809966 | Bruce Henry Blank | Urology | 164 Nw Macleay Blvd, Portland, OR 97210-3323 | 2006-09-12 |
| 1396854121 | Michael J Raife | Urology | 727 S Wahanna Road, Portland, OR 97138-7735 | 2006-08-29 |
| 1184660813 | Kirit S Shah | Urology | 171 Ne 102nd Avenue, Portland, OR 97220-4169 | 2006-06-21 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on DR. AMANDA ALLAN VANDLAC.
| 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.