DR. PRESTON LANE PETERSON (NPI# 1245201508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245201508 |
| Entity Type | Individual |
| Full Name | DR. PRESTON LANE PETERSON |
| Credential | MD |
| Practice Address |
2701 Nw Vaughn St Suite 160 Portland OR 97210-5311 |
| Practice Telephone | 5034995200 |
| Practice Fax Number | 5034995455 |
| Mailing Telephone | 5034995200 |
| Mailing Fax Number | 5034995455 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2010-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
MD60167468 | WA | Allopathic & Osteopathic Physicians |
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
MD25733 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801453030 | Preston Lee Peterson | Nurse Practitioner | 1500 E 2nd St Ste 100, Reno, NV 89502-1189 | 2019-05-22 |
| Street Address |
2701 NW VAUGHN ST SUITE 160 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-5311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366424228 | Todd Jason Cruz | Physical Therapist | 2701 Nw Vaughn St, Ste 155, Portland, OR 97210-5311 | 2005-11-16 |
| 1568008803 | Jeffrey Allen Cusumano | Physical Therapist | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2019-11-21 |
| 1255855706 | Amanda J Tudeen | Occupational Therapist | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2017-07-26 |
| 1952822272 | Hannah Jane Winchester | Physical Therapist | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2017-06-28 |
| 1982078945 | Ashlee Irwin | Social Worker | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2015-11-13 |
| 1073905543 | Alejandro Nevarez | Social Worker | 2701 Nw Vaughn St, Suite 140, Portland, OR 97210-5311 | 2015-02-20 |
| 1235552209 | Christopher Danish | Social Worker | 2701 Nw Vaughn St, Suite 140, Portland, OR 97210 | 2014-01-28 |
| 1407285836 | Catherine S. Chow | Dietitian, Registered | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2013-11-06 |
| 1003181983 | Jeni Lynne Shilman | Social Worker | 2701 Nw Vaughn St, Portland, OR 97210-5311 | 2012-03-12 |
| 1558635078 | Mary Robinette H Fitzsimmons | Social Worker | 2701 Nw Vaughn St, Ste 140, Portland, OR 97210-5311 | 2012-03-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 |
|---|---|---|---|---|
| 1093916470 | Kellie Rooney Foster | Internal Medicine | 2710 Nw Vaughn St, Suite 160, Portland, OR 97210-5344 | 2007-05-31 |
| 1447310859 | Karen Kruse | Internal Medicine | 8200 Se Barbara Welch Rd, Portland, OR 97236-5335 | 2006-12-08 |
| 1083729214 | Stephen Arnold Ebert | Internal Medicine | 2701 Nw Vaughn St., Suite 160, Portland, OR 97201 | 2006-08-20 |
| 1609892736 | Paul Gowen | Internal Medicine | 3635 Ne Alameda St, Portland, OR 97212-1812 | 2006-07-14 |
| 1669418810 | Douglas Reed Grossnickle | Internal Medicine | 10373 Ne Hancock, Suite 219, Portland, OR 97220 | 2006-06-22 |
| 1457324949 | George Goodstein | Internal Medicine | 5100 Sw Macadam Ave, Suite 200, Portland, OR 97239-6102 | 2006-02-07 |
| 1497757447 | Luis Felipe Rodriguez | Internal Medicine | 13007 Ne Glisan St, Portland, OR 97230-2545 | 2005-08-10 |
| 1518372606 | Paul R Porter Md | Internal Medicine | 934 S Broadway St, Ste 3, Portland, TN 37148-1700 | 2014-06-26 |
| 1093128571 | Lisa Kendell Sanders | Internal Medicine | 5050 Ne Hoyt St Ste 540, Portland, OR 97213 | 2014-06-03 |
| 1457642373 | Sandhya Venkata Srikantom | Internal Medicine | 3710 Sw Us Veterans Hospital Rd, Attn P3med, Portland, OR 97239-2964 | 2011-04-26 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on DR. PRESTON LANE PETERSON.
| 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.