RICHARD J KONKOL (NPI# 1417041989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417041989 |
| Entity Type | Individual |
| Full Name | RICHARD J KONKOL |
| Credential | M.D. PHD |
| Practice Address |
3550 North Interstate Ave Medical Office East Portland OR 97227-1097 |
| Mailing Address |
3550 N. Interstate Ave Portland OR 97227 |
| Practice Telephone | 5033315040 |
| Practice Fax Number | 5033315044 |
| Mailing Telephone | 5033315040 |
| Mailing Fax Number | 5033315044 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
MD18039 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
3550 NORTH INTERSTATE AVE MEDICAL OFFICE EAST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750567608 | Ehsan Seyedhossini | Pharmacist | 3550 North Interstate Ave, Portland, OR 97227 | 2008-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
| Find all providers in zip 97227 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689093817 | Artur Riddle | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3079 | 2014-04-15 |
| 1033535463 | Providence Health & Services - Oregon | Psychiatry & Neurology | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2014-03-10 |
| 1689017048 | Ittai Bushlin | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2013-04-16 |
| 1851633077 | Joshua J Kim | Psychiatry & Neurology | 9427 Sw Barnes Rd Ste 395, Portland, OR 97225-6652 | 2013-03-26 |
| 1639436074 | Alison Christy | Psychiatry & Neurology | 9427 Sw Barnes Rd, Suite 395, Portland, OR 97225-6652 | 2012-04-23 |
| 1205094406 | Jenny Lupovici Wilson | Psychiatry & Neurology | 707 Sw Gaines St, Portland, OR 97239-2901 | 2008-05-26 |
| 1487709259 | Erika Lee Finanger | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Cdrc-p, Portland, OR 97239-3011 | 2007-01-24 |
| 1386796266 | Jennifer Clare Huffman | Psychiatry & Neurology | 501 N Graham St, Suite 330a, Portland, OR 97227-1654 | 2007-01-18 |
| 1295743722 | Colin Matthew Roberts | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-08-03 |
| 1356358287 | Stephen Arthur Back | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-08-02 |
| 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.