STACY NICOLE REED (NPI# 1285891168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285891168 |
| Entity Type | Individual |
| Full Name | STACY NICOLE REED |
| Credential | MD |
| Practice Address |
13305 Nw Cornell Rd Ste C Portland OR 97229-5987 |
| Practice Telephone | 5037655000 |
| Practice Fax Number | 8667420249 |
| Mailing Telephone | 5037655000 |
| Mailing Fax Number | 8667420249 |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2020-10-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | MD60215670 | WA | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | MD153328 | OR | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD60215670 | WA | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
MD153328 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500646390 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715216 | Stacy Michelle Reed | Specialist | 121 Lonnie Jenkins Dr, Pearl, MS 39208-3520 | 2020-09-22 |
| 1205352234 | Stacy Joy Reed | Social Worker | 77 E Berkeley St, Boston, MA 02118-2249 | 2017-08-22 |
| 1093121329 | Stacy Reed | Massage Therapist | 153 W Candler St, Winder, GA 30680-1738 | 2014-07-08 |
| 1861667883 | Stacy J. Reed | Student in an Organized Health Care Education/Training Program | 65a Williamsburg Sq, Williamsville, NY 14221-6431 | 2008-04-30 |
| Street Address |
13305 NW CORNELL RD STE C |
| City | PORTLAND |
| State | OR |
| Zip Code | 97229-5987 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881097194 | Reed Dermatology Northwest LLC | Dermatology | 13305 Nw Cornell Rd Ste C, Portland, OR 97229-5987 | 2014-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919906 | Anjana Rajan | Counselor | Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 | 2020-07-06 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1669026134 | Alexandra Elizabeth Lodwig | Speech-Language Pathologist | 255 Nw Lost Springs Terrace Apt 304, Portland, OR 97229 | 2019-08-01 |
| 1003316043 | Jenny Lavonne Thom | Counselor | 15220 Nw Laidlaw Rd., Suite 280, Portland, OR 97229 | 2018-02-16 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1568988913 | Hannah Hendrix Klingelheber | Speech-Language Pathologist | 15605 Nw Ryegrass St., Portland, OR 97229 | 2017-08-17 |
| 1548791213 | Adeline Mitchell | Registered Nurse | 14600 Sw Cornell Rd., Portland, OR 97229 | 2017-03-24 |
| 1538610670 | Crystal Graves | Peer Specialist | 14600 Nw Cornell, Portland, OR 97229 | 2016-10-24 |
| 1639533185 | Evelin James | Dental Hygienist | 5879 Nw Lark Meadow Ter, Portland, OR 97229 | 2016-04-11 |
| Find all providers in zip 97229 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508303561 | Carter Kroeplin Haag | Dermatology | 3303 S Bond Ave # 16d, Portland, OR 97239-4501 | 2017-01-27 |
| 1043765134 | Noelle Teske | Dermatology | 3303 S Bond Ave Fl 16, Portland, OR 97239-4501 | 2016-08-18 |
| 1134579535 | Caroline Morris | Dermatology | 3303 S Bond Ave # Chh16d, Portland, OR 97239-4501 | 2016-06-16 |
| 1033539184 | Natasha Fewkes Carter | Dermatology | 4914 Sw 1st Ave, Portland, OR 97239-2883 | 2014-04-16 |
| 1538588504 | Elizabeth Berry | Dermatology | Ohsu Department of Dermatology, 3303 Sw Bond Ave Ch 16d, Portland, OR 97239-4501 | 2014-04-07 |
| 1124250584 | Einar Axel Juhlin | Dermatology | 340 Eastern Promenade, Unit 154, Portland, ME 04101-2754 | 2009-08-19 |
| 1902040777 | Rajan P Kulkarni | Dermatology | 3303 Sw Bond Ave Ste 16, Portland, OR 97239 | 2009-04-23 |
| 1124280540 | Omar N Qutub | Dermatology | 1129 Nw 11th Ave, Portland, OR 97209-3469 | 2008-06-26 |
| 1427243591 | Robert Bickford Amon | Dermatology | 1700 Sw Broadway Dr, Portland, OR 97201-2211 | 2007-09-11 |
| 1528250727 | Sabra Lofgren Leitenberger | Dermatology | 3303 Sw Bond Avenue Ch 16d, Ohsu Dermatology, Portland, OR 97239 | 2007-08-13 |
| Find all providers in PORTLAND | ||||
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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.