PORTLAND SPINE & NECK SURGERY, P.C. (NPI# 1265615876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265615876 |
| Entity Type | Organization |
| Organization Name | PORTLAND SPINE & NECK SURGERY, P.C. |
| Practice Address |
9155 Sw Barnes Rd Ste 210 Portland OR 97225-6629 |
| Practice Telephone | 5035463503 |
| Practice Fax Number | 5035463507 |
| Mailing Telephone | 5035463503 |
| Mailing Fax Number | 5035463507 |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2009-07-15 |
| Authorized Official Name | MARK C. WESTON (PRESIDENT/OWNER) |
| Authorized Official Telephone | 5035463503 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
MD22218 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
9155 SW BARNES RD STE 210 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265640833 | Donald L Mulconrey | Neurological Surgery | 9155 Sw Barnes Rd Ste 210, Portland, OR 97225-6629 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043605454 | Michael Wheeler | Orthopaedic Surgery | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2015-04-02 |
| 1700203338 | Renuka Reddy Kuruvalli | Orthopaedic Surgery | 3181 Sw Sam Jackson Park Rd, Orthopaedic and Rehabilitaion Department, Portland, OR 97239-3011 | 2014-03-20 |
| 1164860193 | Satoshi Kawaguchi | Orthopaedic Surgery | 3181 Sw Sam Jackson Park Rd, Op31, Portland, OR 97239-3011 | 2013-06-12 |
| 1225293285 | Emily C Nguyen | Orthopaedic Surgery | 1515 Nw 18th Ave, Ste 300, Portland, OR 97209-2539 | 2008-07-18 |
| 1659565042 | Durairaj Jagajeevanram | Orthopaedic Surgery | 3181 Sw Sam Jackson Park Road, Suite 2360, Sam Jackson Hall, Portland, OR 97239 | 2007-08-29 |
| 1841266335 | Jeffrey Edward Flemming | Orthopaedic Surgery | 5050 Ne Hoyt St, Ste 611, Portland, OR 97213-2991 | 2006-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932607215 | Spine Cin of Oregon LLC | Orthopaedic Surgery | 1867 Williams Hwy Ste 287, Grants Pass, OR 97527-5854 | 2018-01-31 |
| 1023516309 | Joint Replacement Cin of Oregon LLC | Orthopaedic Surgery | 1867 Williams Hwy Ste 288, Grants Pass, OR 97527-5856 | 2018-01-31 |
| 1912349580 | Southern Oregon Spine Care, P.C. | Orthopaedic Surgery | 1311 Barnett Road Ste 201, Medford, OR 97504 | 2013-07-24 |
| 1063722262 | Centennial Medical Group North, LLC | Orthopaedic Surgery | 2801 Nw Mercy Dr Ste 340, Roseburg, OR 97471-2348 | 2010-10-21 |
| 1295779734 | Todd Jay Lewis | Orthopaedic Surgery | 2211 Nw Professional Dr, Ste 100, Corvallis, OR 97330-3887 | 2006-06-15 |
| 1699763607 | Mark Delano Peterson | Orthopaedic Surgery | 1311 E Barnett Rd, Ste 201, Medford, OR 97504-8225 | 2005-10-12 |
| 1548722614 | Sor Care of Or, LLC | Orthopaedic Surgery | 1867 Williams Hwy Ste 287, Grants Pass, OR 97527-5854 | 2019-04-05 |
| 1942702642 | Robert L Tatsumi Md PC | Orthopaedic Surgery | 19255 Sw 65th Ave Ste 200, Tualatin, OR 97062-9712 | 2018-03-08 |
| 1376972182 | Oregon Spine Care LLC | Orthopaedic Surgery | 19255 Sw 65th Ave, Suite 200, Tualatin, OR 97062-7451 | 2013-11-02 |
| 1568707883 | Mark Weston, Md, LLC | Orthopaedic Surgery | 4309 Oakridge Rd, Lake Oswego, OR 97035-3418 | 2012-11-28 |
| 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.