SUSAN H GERVASI (NPI# 1255437273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255437273 |
| Entity Type | Individual |
| Full Name | SUSAN H GERVASI |
| Other Name | SUSAN HAYES |
| Credential | WHCNP, BSN |
| Practice Address |
10100 Se Sunnyside Rd Clackamas OR 97015-8970 |
| Mailing Address |
13683 Se 127th Ave Clackamas OR 97015-7302 |
| Practice Telephone | 5037868435 |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
OR 083042345N7 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10100 SE SUNNYSIDE RD |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-8970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942276969 | Jeanette L. Tanega | Physician Assistant | 10100 Se Sunnyside Rd, Mt. Talbert Medical Office, Clackamas, OR 97015-8970 | 2006-02-28 |
| 1154935252 | Hayley Hirt | Registered Nurse | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2020-09-04 |
| 1073017463 | Donna Delaine Eoff | Nurse Practitioner | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2018-03-20 |
| 1043752777 | Heather Carey | Registered Nurse | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2016-11-11 |
| 1891247797 | Christopher Curtis Caswell | Pharmacist | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2016-10-26 |
| 1164973236 | Kaiser Foundation Health Plan of The Northwest | General Practice | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2016-10-24 |
| 1518416676 | Julie Khuu | Pharmacist | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2016-09-29 |
| 1619425733 | Brett Caldwell | Pharmacist | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2016-09-18 |
| 1700258530 | Christina Nichole Farrell | Nurse Practitioner | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2015-10-20 |
| 1851739320 | Angela Christine Dunscomb | Physical Therapist | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2013-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053580761 | Mary Elizabeth Craft | Nurse Practitioner | 10100 Sunnyside Road, Clackamas, OR 97015 | 2008-02-27 |
| 1598877367 | Elizabeth Mary Ross | Nurse Practitioner | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-08-31 |
| 1821104589 | Diane Marie Kintz | Nurse Practitioner | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760043673 | Tracy Lee Stevens | Nurse Practitioner | 2222 Ne 130th Ave, Portland, OR 97230-1705 | 2019-06-23 |
| 1093292971 | Tracie Lynn Wright | Nurse Practitioner | 572 Barton Rd, Eagle Point, OR 97524-4405 | 2018-07-24 |
| 1780048124 | Degrazia Wellness, LLC | Nurse Practitioner | 3210 Hillcrest Park Dr, Suite 100, Medford, OR 97504-7693 | 2016-04-12 |
| 1740650134 | Sara Brelsford | Nurse Practitioner | 1075 Sw Grandview Avenue, Suite 200, Grants Pass, OR 97527 | 2015-09-29 |
| 1013307685 | Christa Elane Degrazia | Nurse Practitioner | 146 Clear Creek Dr, Suite 350, Ashland, OR 97520-1851 | 2015-02-03 |
| 1699186395 | Jennifer Marie Kowalczyk | Nurse Practitioner | 715 Nw Dimmick St, Grants Pass, OR 97526-1536 | 2014-05-15 |
| 1558782318 | Rebecca M Meek | Nurse Practitioner | 2430 S 6th St, Klamath Falls, OR 97601-4342 | 2013-12-21 |
| 1184055931 | Sue Lillian Dixon | Nurse Practitioner | 715 S.w. 4th St., Ste.c, Madras, OR 97741 | 2013-12-04 |
| 1689004053 | Kendra Parkin | Nurse Practitioner | 12220 Sw 1st St, Suite 200, Beaverton, OR 97005-2889 | 2013-11-20 |
| 1467742205 | Jennifer Lynda Roberson | Nurse Practitioner | 12550 Sw 2nd St, Beaverton, OR 97005-0519 | 2011-04-13 |
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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.