DAVID E GANNETT JR. (NPI# 1467454165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467454165 |
| Entity Type | Individual |
| Full Name | DAVID E GANNETT JR. |
| Credential | MD |
| Practice Address |
9205 Sw Barnes Rd Portland OR 97225-6603 |
| Mailing Address |
847 Ne 19th Ave Suite 300 Portland OR 97232-2684 |
| Practice Telephone | 5032162195 |
| Practice Fax Number | 5032162196 |
| Mailing Telephone | 5039632801 |
| Mailing Fax Number | 5039632825 |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2013-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
MD20984 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 150948 | 05 | |
| WA | 8220857 | 05 |
| Street Address |
9205 SW BARNES RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326041526 | Nate D Quilici | Specialist | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2005-05-23 |
| 1487251773 | Leah Burke Chapman | Nurse Practitioner | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-10-08 |
| 1366054819 | Jennifer Haas Pierron | Registered Nurse | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-08-17 |
| 1831717974 | Steffany Bixby | Dietitian, Registered | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-07-06 |
| 1477174076 | Nathaniel Edwards | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1801417407 | Karissa Kunihira | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1720609324 | Jakob Feeney | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1710508320 | Banu Ramachandran | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-05 |
| 1083235964 | Amy Pohodich | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-01 |
| 1740801620 | Steven C Freeman | Student in an Organized Health Care Education/Training Program | 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 2020-05-01 |
| 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 | 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.