DEREK NATHAN ANDERSON (NPI# 1255491635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255491635 |
| Entity Type | Individual |
| Full Name | DEREK NATHAN ANDERSON |
| Credential | MD |
| Practice Address |
1105 Portland Ave Suite 2 Gladstone OR 97027-2170 |
| Mailing Address |
Po Box 92900 Portland OR 97292-0900 |
| Practice Telephone | 5036552404 |
| Practice Fax Number | 5036551581 |
| Mailing Telephone | 5036552404 |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2016-04-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD169675 | OR | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 36375 | IA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500682438 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326659798 | Derek Miles Anderson | Nurse Practitioner | 545 Woodward Dr, Fayetteville, GA 30215-7641 | 2020-08-11 |
| 1619476314 | Derek Joshua Anderson | Physical Therapist | 3515 Fannin St Ste 101, Beaumont, TX 77701-3810 | 2018-02-08 |
| 1023558434 | Derek Anderson | Specialist/Technologist | 1227 E Hillcourt, Williston, ND 58801-4454 | 2017-03-03 |
| 1770884546 | Derek Steven Anderson | Chiropractor | 14413 Excelsior Blvd, Minnetonka, MN 55345-5821 | 2010-11-10 |
| 1821069485 | Derek W Anderson | Anesthesiology | 617 E 3900 S, Salt Lake City, UT 84107-1901 | 2006-01-31 |
| 1477181006 | Derek Anderson | Community Health Worker | 120 W Main St, Mesquite, TX 75149-4264 | 2020-03-30 |
| 1497297634 | Derek Anderson | Nutritionist | 6600 Van Aalst Blvd, Building 9250, Fort Benning, GA 31905 | 2016-11-04 |
| 1003364928 | Derek Ryan Anderson | Psychologist | 9600 Veterans Dr Sw, Rehabilitation Care Service (a-117-rcs), Tacoma, WA 98493-0003 | 2016-09-20 |
| 1972976959 | Derek Anderson | Case Manager/Care Coordinator | 111 North St, Rapid City, SD 57701-1163 | 2015-11-12 |
| 1568468171 | Derek James Anderson | Family Medicine | 9001 Summa Ave, Baton Rouge, LA 70809-3726 | 2005-06-28 |
| Street Address |
1105 PORTLAND AVE SUITE 2 |
| City | GLADSTONE |
| State | OR |
| Zip Code | 97027-2170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568422103 | Candace Lee Krause | Dentist | 1105 Portland Ave, Gladstone, OR 97027-2156 | 2006-03-27 |
| 1881860914 | Gladstone Family Dentistry | Clinic/Center | 1105 Portland Ave, Gladstone, OR 97027-2170 | 2008-05-08 |
| 1972686160 | Pamela L Bullock | Internal Medicine | 1105 Portland Ave, Suite 2, Gladstone, OR 97027-2170 | 2006-10-23 |
| 1922116359 | Jeremy S Kato | Dentist | 1105 Portland Ave, Gladstone, OR 97027-2170 | 2006-08-27 |
| 1568412351 | Gerald Marlin King | Family Medicine | 1105 Portland Ave, Suite 2, Gladstone, OR 97027-2170 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484270 | Patricia Ann Combs | Massage Therapist | 255 E. Dartmouth St., Gladstone, OR 97027 | 2020-07-09 |
| 1376036764 | Gladstone Smiles Dentistry PC | Dentist | 20140 Mcloughlin Blvd, Gladstone, OR 97027 | 2018-06-11 |
| 1194111344 | Kacey Danyelle Dahmen | Behavioral Analyst | 890 Se 82nd Drive, Gladstone, OR 97027 | 2015-04-14 |
| 1255738092 | Western Psychological and Counseling Services PC | Community/Behavioral Health | 870 Se 82nd, Gladstone, OR 97027 | 2014-11-21 |
| 1548678097 | James Lee Briscoe | Counselor | 870 Se 82nd Dr., Bldg. C, Gladstone, OR 97027 | 2014-07-29 |
| 1003164690 | Chloe Elizabeth Lee-zorn | Psychologist | 890 Se 82nd, Gladstone, OR 97027 | 2012-08-29 |
| 1700187408 | Leonard Cogan | Counselor | 887 82nd Dr, Bldg C, Gladstone, OR 97027 | 2010-11-11 |
| 1851525620 | Sarah Morgan Schrauben | Psychiatry & Neurology | 870 Se 82nd Ave., Portland, OR 97027 | 2009-05-08 |
| 1093971640 | Western Psychological and Counseling Services PC | Counselor | 9670 Sw Beaverton-hillsdale Hwy, Beaverton, OR 97027 | 2008-08-04 |
| 1578606935 | Myron John Welbes | Counselor | 17663 Se 82nd Drive, Gladstone, OR 97027 | 2007-02-15 |
| Find all providers in zip 97027 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982877841 | Cynthia M Worden | Family Medicine | 15 82nd Dr Ste 100, Gladstone, OR 97027-2550 | 2008-04-10 |
| 1316068919 | Sean Scott Harper | Family Medicine | 1105 Portland Ave Ste 2, Gladstone, OR 97027-2170 | 2007-04-02 |
| 1336281534 | Dr. J.a. Direnna Jr, P.C. | Family Medicine | 1 The Woodlands, Gladstone, MO 64119-1853 | 2007-02-13 |
| 1609884436 | Mary C Whitmer | Family Medicine | 128 Michigan Ave, Gladstone, MI 49837-1929 | 2006-08-04 |
| 1558399014 | Catherine Alpha Anderson | Family Medicine | 6651 N Oak Trfy Ste 3, Gladstone, MO 64118-3353 | 2006-06-30 |
| 1447298385 | Timothy C. Frey | Family Medicine | 5601 N. Antioch, Creekwood Family Care, Ste. 12, Gladstone, MO 64119 | 2006-06-03 |
| 1417919283 | Jayhawk Primary Care Inc | Family Medicine | 6420 N Prospect Ave, Gladstone, MO 64119-1530 | 2006-04-05 |
| 1558901413 | Portland Adventist Medical Center | Family Medicine | 19220 Mcloughlin Blvd, Gladstone, OR 97027-2642 | 2020-01-08 |
| 1154877157 | Gladstone Family Care, LLC | Family Medicine | 6717 N Oak Trfy, Gladstone, MO 64118-3346 | 2016-08-30 |
| 1235576752 | Justin Scott Lawing | Family Medicine | 6420 N Prospect Ave, Gladstone, MO 64119 | 2013-05-23 |
| Find all providers in GLADSTONE | ||||
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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.