MARTHA WIGGERS (NPI# 1407241490) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407241490 |
| Entity Type | Individual |
| Full Name | MARTHA WIGGERS |
| Other Name | MARTHA SICKING |
| Credential | PA-C |
| Practice Address |
9701 Sw Barnes Rd Suite 150 Portland OR 97225-6772 |
| Mailing Address |
7650 Sw Beveland Rd Suite 200 Portland OR 97223-8692 |
| Practice Telephone | 5037343535 |
| Practice Fax Number | 5037343530 |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2016-08-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 172159 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA172159 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | MEDICARE PTAN | R186744 | 01 |
| OR | 500698025 | 05 |
| Street Address |
9701 SW BARNES RD SUITE 150 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6772 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386640688 | Philip T Alexander | Surgery | 9701 Sw Barnes Rd, Ste 140, Portland, OR 97225 | 2005-06-22 |
| 1225588924 | West Hills Gastroenterology Equipment Corp | Clinic/Center | 9701 Sw Barnes Rd, Suite 310, Portland, OR 97225-6772 | 2016-10-06 |
| 1053720201 | Sarah Elizabeth Hadfield | Physician Assistant | 9701 Sw Barnes Rd, Suite 130, Portland, OR 97225-6772 | 2014-08-12 |
| 1780099366 | Katherine J Snow | Social Worker | 9701 Sw Barnes Rd, Suite 299, Portland, OR 97225-6772 | 2014-06-23 |
| 1215278361 | Bailey A Hasty | Physician Assistant | 9701 Sw Barnes Rd, Suite 200, Portland, OR 97225-6772 | 2013-03-13 |
| 1740542919 | Jessica D Benedict | Nurse Practitioner | 9701 Sw Barnes Rd, Suite 200, Portland, OR 97225-6772 | 2012-06-13 |
| 1326314196 | Praestantia Associates, LLC | Nurse Anesthetist, Certified Registered | 9701 Sw Barnes Rd, Suite 150, Portland, OR 97225-6772 | 2012-03-27 |
| 1720387954 | Metropolitan Anesthesia LLC | Nurse Anesthetist, Certified Registered | 9701 Sw Barnes Rd, Suite 300, Portland, OR 97225-6772 | 2011-03-28 |
| 1225359987 | Margot Louise Herman | Internal Medicine | 9701 Sw Barnes Rd, Suite 300, Portland, OR 97225-6772 | 2010-06-17 |
| 1013172840 | The Oregon Clinic PC | Clinic/Center | 9701 Sw Barnes Rd, Suite 310, Portland, OR 97225-6772 | 2008-07-21 |
| Find all providers in the same location | ||||
| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1396250122 | Saron Theresa Sufuentes | Physician Assistant | 578 Nw Marlborough Ave, Portland, OR 97210-3104 | 2017-12-01 |
| 1952775520 | Lauren Govier | Physician Assistant | 501 N Graham St Ste 415, Portland, OR 97227-2006 | 2015-11-19 |
| 1619346368 | Ryan Mcmahon | Physician Assistant | 3415 Ne 20th Ave, Portland, OR 97212-2416 | 2015-09-23 |
| 1881090033 | Sanja Bukarac | Physician Assistant | 20 Buca Run, Portland, ME 04103-1427 | 2014-11-17 |
| 1194130716 | Nicole Lessard | Physician Assistant | 27 Bramhall St, Portland, ME 04102 | 2014-06-23 |
| 1528499910 | Elan Kennedy | Physician Assistant | 3181 Sw Sam Jackson Park Rd., Mail Code L353, Ohsu, Division of Cardiothoracic Surgery, Portland, OR 97239 | 2013-12-10 |
| 1013161405 | Lorraine Walburga Gohman | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2008-11-11 |
| 1841472065 | Mandy Melissa Williams | Physician Assistant | 265 N Broadway, Portland, OR 97227-1800 | 2007-11-29 |
| 1063612455 | Donald R Noel | Physician Assistant | 10101 Se Main St Ste 3008, Portland, OR 97216-2458 | 2007-07-23 |
| 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.