DR. ANDREA W. SOULE (NPI# 1255482287) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255482287 |
| Entity Type | Individual |
| Full Name | DR. ANDREA W. SOULE |
| Credential | D.O. |
| Practice Address |
4060 Sw 110th Ave Beaverton OR 97005-3017 |
| Mailing Address |
Po Box 1843 Beaverton OR 97075-1843 |
| Practice Telephone | 5033491884 |
| Practice Fax Number | 5033500301 |
| Mailing Telephone | 5033491884 |
| Mailing Fax Number | 5033500301 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2012-04-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | DO28362 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | TAX ID | 71-0968273 | 01 |
| Street Address |
4060 SW 110TH AVE |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97005-3017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275508780 | Leah Joy Bowder | Massage Therapist | 4060 Sw 110th Ave, Beaverton, OR 97005-3017 | 2006-02-18 |
| 1376808246 | Anthony Tangalin | Specialist | 4060 Sw 110th Ave, Beaverton, OR 97005-3017 | 2012-07-06 |
| 1942562947 | Touchworks LLC | Specialist | 4060 Sw 110th Ave, Beaverton, OR 97005-3017 | 2012-06-14 |
| 1164752192 | Rachel Joyce | Specialist | 4060 Sw 110th Ave, Beaverton, OR 97005-3017 | 2010-01-14 |
| 1770812943 | Miriam Sharon Rose | Neuromusculoskeletal Medicine & OMM | 4060 Sw 110th Ave, Beaverton, OR 97005-3017 | 2009-12-16 |
| 1699922799 | Cydney Elaine Hildreth | Massage Therapist | 4060 Sw 110th Ave, Beaverton, OR 97005-3017 | 2008-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945053 | Krista Lowe Schimmelbusch | Student in an Organized Health Care Education/Training Program | 12730 Sw 3rd St., Beaverton, OR 97005 | 2020-06-05 |
| 1346882578 | Mireya Elissa Nunez I | Counselor | 12665 Sw Center Street, Suite 100, Beaverton, OR 97005 | 2019-10-09 |
| 1548816879 | Logan James Patzlaff | Behavior Technician | 6200 Sw Artic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-08-13 |
| 1528521424 | Alex Taylor Foerman | Behavior Technician | 6200 Sw Arctic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-04-09 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1992286348 | Kathryn Wallner | Counselor | 14205 Sw Farmington Road, Suite 160, Beaverton, OR 97005 | 2018-08-23 |
| 1699265058 | Meaghan Mikulic | Social Worker | 14355 Sw Allen Blvd Suite 150, Beaverton, OR 97005 | 2018-05-11 |
| 1629568936 | Aimee J Nelson | Massage Therapist | 10700 Sw Beaverton Hillsdale Hwy Ste 465, Beaverton, OR 97005 | 2018-05-11 |
| 1093221780 | Ember Dahl | Massage Therapist | 12655 Sw Center St Ste 530, Beaverton, OR 97005 | 2017-12-18 |
| 1033667456 | Andre Vo | Pharmacist | 2575 Sw Walker Rd, Beaverton, OR 97005 | 2016-09-14 |
| Find all providers in zip 97005 | ||||
| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770812943 | Miriam Sharon Rose | Neuromusculoskeletal Medicine & OMM | 4060 Sw 110th Ave, Beaverton, OR 97005-3017 | 2009-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720614449 | Keith Turner Slicho, Do, PC | Neuromusculoskeletal Medicine & OMM | 700 Ne Multnomah St Ste 330, Portland, OR 97232-4103 | 2020-03-13 |
| 1891165544 | Still Point Osteopathy and Medical Acupuncture, LLC | Neuromusculoskeletal Medicine & OMM | 2955 N Highway 97, Bend, OR 97703-7559 | 2015-10-06 |
| 1336549179 | Anna Lobzova | Neuromusculoskeletal Medicine & OMM | 3620 Nw Samaritan Dr Ste 203a, Corvallis, OR 97330-4714 | 2014-08-29 |
| 1508203332 | Brian Moreaux | Neuromusculoskeletal Medicine & OMM | 850 Siskiyou Blvd Ste 7, Ashland, OR 97520-2125 | 2013-06-03 |
| 1427301035 | Patrick J Wedlake Do PC | Neuromusculoskeletal Medicine & OMM | 85o Siskiyou Blvd, Ste 9, Ashland, OR 97520-2125 | 2012-10-19 |
| 1548402811 | Juliette Sophie Preston | Neuromusculoskeletal Medicine & OMM | 3303 Sw Bond Ave Fl 8, Portland, OR 97239-4501 | 2009-04-01 |
| 1528231636 | Hannah M Fine | Neuromusculoskeletal Medicine & OMM | 1007 Harlow Rd Ste 310, Springfield, OR 97477-7127 | 2008-04-09 |
| 1093841397 | Thomas David Peterson | Neuromusculoskeletal Medicine & OMM | 1178 Charnelton St, Eugene, OR 97401-3431 | 2007-02-23 |
| 1063589323 | Paul E Dart | Neuromusculoskeletal Medicine & OMM | 3495 Harris Street, Eugene, OR 97405-4248 | 2006-11-29 |
| 1629147400 | Paula Lorene Eschtruth | Neuromusculoskeletal Medicine & OMM | 1320 Edgewater St Nw, Suite 110, Salem, OR 97304 | 2006-11-07 |
| Find all providers with the same taxonomy | ||||
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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.