THE VASCULAR AND INTERVENTIONAL GROUP, LLC (NPI# 1265908289) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265908289 |
| Entity Type | Organization |
| Organization Name | THE VASCULAR AND INTERVENTIONAL GROUP, LLC |
| Practice Address |
25030 Sw Parkway Ave Ste 200 Wilsonville OR 97070-9816 |
| Practice Telephone | 5036120498 |
| Practice Fax Number | 5034590521 |
| Mailing Telephone | 5036120498 |
| Mailing Fax Number | 5034590521 |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |
| Authorized Official Name | MANDY BOUSCHOR (ADMINISTRATOR) |
| Authorized Official Telephone | 5036120498 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | THE VASCULAR AND INTERVENTIONAL GROUP, LLC | 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070 |
| Street Address |
25030 SW PARKWAY AVE STE 200 |
| City | WILSONVILLE |
| State | OR |
| Zip Code | 97070-9816 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326029950 | Jason Richard Bauer | Radiology | 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 | 2005-11-10 |
| 1609210632 | Michael Alan Bevilacqua | Radiology | 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 | 2013-04-22 |
| 1629339155 | Leonardo A Campos | Internal Medicine | 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 | 2012-05-31 |
| 1770889388 | Interventional and Vascular Consultants PC | Radiology | 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 | 2011-01-28 |
| 1467681957 | Jaime Walton All | Radiology | 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 | 2009-07-06 |
| 1629138409 | Michael Eli Pfister | Radiology | 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457995896 | Rosalyn Sharon Mckinney | Technician | 7798 Sw Vlahos Dr, Wilsonville, OR 97070 | 2019-10-29 |
| 1275027393 | Oregon Regeneration Stem Cell Medical Center, LLC | Chiropractor | 29781 Sw Town Center Loop, Wilsonville, OR 97070 | 2018-06-21 |
| 1073050472 | Kirstin Marie Lauritzen | Chiropractor | 25589 Sw Canyon Creek Rd Ste 100, Wilsonville, OR 97070 | 2017-01-23 |
| 1932642220 | Nicole Galasso | Occupational Therapy Assistant | 25117 Sw Parkway Avenue Suite D, Wilsonville, OR 97070 | 2016-11-18 |
| 1508317512 | Justin Langlais | Naturopath | 25195 Sw Parkway Ave Ste 210, Wilsonville, OR 97070 | 2016-10-14 |
| 1518411149 | Stephanie Tran | Optometrist | 29250 Town Center Loop W, Wilsonville, OR 97070 | 2016-08-11 |
| 1346610607 | Rachel Ziegler | Occupational Therapy Assistant | 25117 Sw Parkway Ave Suite D, Willsonville, OR 97070 | 2015-09-30 |
| 1992184238 | Michelle Miranda | Counselor | 30150 Sw Parkway Ave Ste 300, Wilsonville, OR 97070 | 2015-05-19 |
| 1609275007 | Ryan Bridges | Dentist | 30040 Sw Boones Ferry Rd Ste 20, Wilsonville, OR 97070 | 2014-08-21 |
| 1649604018 | Jason Russell James | Physical Therapist | 29174 Sw Town Center Loop W # 202b, Wilsonville, OR 97070 | 2013-08-21 |
| Find all providers in zip 97070 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770889388 | Interventional and Vascular Consultants PC | Radiology | 25030 Sw Parkway Ave Ste 200, Wilsonville, OR 97070-9816 | 2011-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356809073 | Medford Radiological Group, PC | Radiology | 1910 E Barnett Rd Ste 104, Medford, OR 97504-8672 | 2019-03-12 |
| 1194282400 | Comprehensive Interventional Care Centers, Pllc | Radiology | 6958 Sw Varns St, Portland, OR 97223-0000 | 2019-02-22 |
| 1538587118 | Masahiro Horikawa | Radiology | 3155 Sw Moody Ave Apt 503, Portland, OR 97239-4733 | 2014-04-01 |
| 1073956991 | Marc Michael Delrosario Lim | Radiology | 3181 Sw Sam Jackson Park Rd # L342, Portland, OR 97239-3011 | 2013-04-10 |
| 1013004548 | Edward Thomas Mcclure | Radiology | 2200 Bryant Williams Dr Fl 2, Klamath Falls, OR 97601-1121 | 2006-10-06 |
| 1700839107 | Dariusz Z Zawierucha | Radiology | 445 Harlow Rd, Springfield, OR 97477 | 2006-05-18 |
| 1588283154 | Pnw Management Group | Radiology | 6958 Sw Varns St, Portland, OR 97223-8281 | 2020-04-13 |
| 1669905261 | Ningcheng Li | Radiology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 | 2017-04-10 |
| 1669868741 | Lisa Walker | Radiology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2015-04-15 |
| 1336568369 | Hasnain A Hasham | Radiology | 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 | 2014-04-07 |
| Find all providers with the same taxonomy | ||||
| City | WILSONVILLE |
| Zip Code | 97070 |
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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.