THOMAS DONALD WYNNE (NPI# 1417945106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417945106 |
| Entity Type | Individual |
| Full Name | THOMAS DONALD WYNNE |
| Credential | M.D. |
| Practice Address |
3620 N Interstate Ave Portland OR 97227-1106 |
| Practice Telephone | 5032802931 |
| Practice Fax Number | 5032802938 |
| Mailing Telephone | 5032802931 |
| Mailing Fax Number | 5032802938 |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2013-01-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
MD19191 | OR | Allopathic & Osteopathic Physicians |
| N | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
MD19191 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851335368 | Thomas W Wynne | Social Worker | 6 Desta Dr, Suite 2640, Midland, TX 79705-5520 | 2006-06-15 |
| 1831564830 | Thomas Frank Wynne | Counselor | 515 Lakeway Dr, Bellingham, WA 98225-5233 | 2015-12-02 |
| 1235292202 | Thomas Declan Wynne | Counselor | 1600 E Olive St, Sound Mental Health, Seattle, WA 98122-2735 | 2006-12-19 |
| Street Address |
3620 N INTERSTATE AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083601835 | Thomas Harry Johnson | Radiology | 3620 N Interstate Ave, Portland, OR 97227-1106 | 2005-10-05 |
| 1033402995 | Aaron Nathaniel Sabolch | Radiology | 3620 N Interstate Ave, Portland, OR 97227-1106 | 2011-05-25 |
| 1093043424 | Kaiser Foundation Health Plan of The Northwest | Clinic/Center | 3620 N Interstate Ave, Portland, OR 97227-1106 | 2009-11-23 |
| 1043208820 | Jaishanker Nautiyal | Radiology | 3620 N Interstate Ave, Portland, OR 97227-1106 | 2005-10-06 |
| 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 | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235549031 | Amar Srivastava | Radiology | 4805 Ne Glisan St, Garden Level, Portland, OR 97213 | 2014-05-01 |
| 1962848655 | Joshua M Walker | Radiology | 3181 Sw Sam Jackson Park Rd # Kpv4, Portland, OR 97239 | 2013-05-21 |
| 1578610382 | Jerry Jeff Jaboin | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Department of Radiation Medicine, Portland, OR 97239-3011 | 2007-01-04 |
| 1770520892 | Katie Anne Deming | Radiology | 1400 Nw Irving St, 527, Portland, OR 97209-2210 | 2006-05-31 |
| 1043299217 | Andrew Yoo Jong Kee | Radiology | 1130 Nw 22nd Ave Ste Ll50, Portland, OR 97210-2900 | 2006-01-16 |
| 1083601835 | Thomas Harry Johnson | Radiology | 3620 N Interstate Ave, Portland, OR 97227-1106 | 2005-10-05 |
| 1356338149 | Misa Melissa Lee | Radiology | 1130 Nw 22nd Avenue, Ll50, Portland, OR 97210-2900 | 2005-10-05 |
| 1952780512 | Blair M Murphy | Radiology | 3181 Sw Sam Jackson Park Rd # Kpv4, Portland, OR 97239-3011 | 2015-05-28 |
| 1114304870 | Eric Michael Chang | Radiology | 3181 Sw Sam Jackson Park Rd # L337, Portland, OR 97239-3011 | 2015-05-01 |
| 1073908505 | Whitney Beeler | Radiology | 22 Bramhall St, Portland, ME 04102-3134 | 2015-04-01 |
| 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.