AGEWELL GERIATRICS, LLC


Address: 13120 Sw Heather Ct, Beaverton, OR 97008-5612
Phone: 5037803708

AGEWELL GERIATRICS, LLC (NPI# 1225698889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225698889
Entity Type Organization
Organization Name AGEWELL GERIATRICS, LLC
Practice Address 13120 Sw Heather Ct
Beaverton
OR 97008-5612
Practice Telephone 5037803708
Practice Fax Number 5036393870
Mailing Telephone 5037803708
Mailing Fax Number 5036393870
Enumeration Date 2019-06-17
Last Update Date 2019-06-17
Authorized Official Name RENEE LADENE REED (OWNER/NURSE PRACTITIONER)
Authorized Official Telephone 5037803708
Authorized Official Credential ANP-C, GNP-BC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
NPI 1154613941 01
OR 500698230 05

Other Data Sources

Entity Type Entity Name Entity Address
Oregon Corporations, Companies and Business Names AGEWELL GERIATRICS, LLC 13120 Sw Heather Court, Beaverton, OR 97008

Office Location

Street Address 13120 SW HEATHER CT
City BEAVERTON
State OR
Zip Code 97008-5612

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1972136638 Kelly Mitchell Counselor 6600 Sw 105th Ave Suite 120, Beaverton, OR 97008 2020-02-20
1700305315 Heather Denise Glenn Counselor 6700 Sw 105th Avenue, Suite 203, Beaverton, OR 97008 2017-09-14
1649798265 Timothy Wilkins Counselor 8285 Sw Nimbus Ave #148, Beaverton, OR 97008 2017-09-04
1962920751 West End Surgical, LLC Clinic/Center 9405 Sw Nimbus Ave, Beaverton, OR 97008 2017-09-01
1073054714 University Professional Services Durable Medical Equipment & Medical Supplies 9317 Sw Nimbus Ave, Beaverton, OR 97008 2017-03-14
1508311424 Mitra Gaspeed Dental Hygienist 8615 Sw Thoroughbred Pl., Beaverton, OR 97008 2016-08-20
1740521988 Donna Louise Grenier Registered Nurse 1413 E St, Independence, OR 97008 2013-03-13
1508105735 Mary Elizabeth Smith Specialist/Technologist, Other 11855sw Ridgecrest Dr, #209, Beaverton, OR 97008 2013-02-07
1629315551 Adelfino J Zuriaga Massage Therapist 11985 Sw Camden Ln, Beaverton, OR 97008 2013-01-11
1760738330 Lih-wern Wang Pharmacist 9775 Sw Gemini Dr Ste 1, Beaverton, OR 97008 2012-07-31
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1972073807 Jenna M Mccummings Nurse Practitioner 439 S Ross St, Beaverton, MI 48612-9101 2018-12-04

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1154956233 Ellen Faye Barlow Nurse Practitioner 506 Fourth St., La Grande, OR 97850 2020-03-09
1760960462 Sid Christian Keomanivong Nurse Practitioner 2677 Beall Ln, Central Point, OR 97502-1462 2018-08-03
1245611771 Karen Musick Nurse Practitioner 3514 Nw Mckinley Dr, Corvallis, OR 97330-1148 2015-06-10
1184054546 Nancy M Burgess Rn Msn Anp-c PC Nurse Practitioner 910 Sw Highway 97 Ste 104, Madras, OR 97741-9247 2013-11-22
1518391804 Sally Elizabeth Kraynik Nurse Practitioner 1895 E Main St, Hillsboro, OR 97123-4345 2013-08-22
1295998920 Paula Jo Cramer Nurse Practitioner 790 S Main St Myrtle, Creek, Ore, Myrtle Creek, OR 97457 2008-07-02
1780855601 Leslie West Nurse Practitioner 51730 Dexter St., Blue River, OR 97413-0183 2008-03-19
1548399322 Corporate Health Nw Nurse Practitioner 10209 Se Division St, Portland, OR 97266-1327 2007-03-05
1962540310 Laura Ann Shattuck Nurse Practitioner 21440 S Upper Highland Rd, Beavercreek, OR 97004-8814 2007-02-01
1699761932 Rogue Valley Physicians Nurse Practitioner 2900 Doctors Park Dr, Medford, OR 97504-8127 2005-09-22
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Competitor

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City BEAVERTON
Zip Code 97008

Improve Information

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Dataset Information

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.

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