MARY-LYNN THEEL (NPI# 1497892145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497892145 |
| Entity Type | Individual |
| Full Name | MARY-LYNN THEEL |
| Credential | M.D. |
| Practice Address |
12250 Sw 2nd St Beaverton OR 97005-2828 |
| Practice Telephone | 5039067481 |
| Practice Fax Number | 5036010049 |
| Mailing Telephone | 5039067481 |
| Mailing Fax Number | 5036010049 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2014-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
17319 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
12250 SW 2ND ST |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97005-2828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558470328 | Milan Sosnovec, Md, PC | Psychiatry & Neurology | 12250 Sw 2nd St, Beaverton, OR 97005-2828 | 2006-08-29 |
| 1548776511 | Robert Charles Ross | Social Worker | 12250 Sw 2nd St, Beaverton, OR 97005-2828 | 2017-12-28 |
| 1356857999 | Bob Ross, Lcsw, LLC | Social Worker | 12250 Sw 2nd St, Beaverton, OR 97005-2828 | 2017-12-19 |
| 1972925014 | Melinda Frank, Lac, LLC | Clinic/Center | 12250 Sw 2nd St, Beaverton, OR 97005-2828 | 2014-01-08 |
| 1134460660 | Melinda Frank | Acupuncturist | 12250 Sw 2nd St, Beaverton, OR 97005-2828 | 2013-03-07 |
| 1356573844 | Jessica Erinn Franzke | Mechanotherapist | 12250 Sw 2nd St, Beaverton, OR 97005-2828 | 2009-08-17 |
| 1396980413 | Jessilyn Leigh Barron | Social Worker | 12250 Sw 2nd St, Suite 106, Beaverton, OR 97005-2828 | 2008-12-03 |
| 1023263779 | Mariacristina Isaza-chapman | Counselor | 12250 Sw 2nd St, Suite 106, Beaverton, OR 97005-2828 | 2008-11-21 |
| 1174795843 | Milan Sosnovec | Psychiatry & Neurology | 12250 Sw 2nd St, Suite #102, Beaverton, OR 97005-2828 | 2008-04-02 |
| 1821128927 | J Teresa Shelby | Psychiatry & Neurology | 12250 Sw 2nd St, Beaverton, OR 97005-2828 | 2007-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945053 | Krista Lowe Schimmelbusch | Student in an Organized Health Care Education/Training Program | 12730 Sw 3rd St., Beaverton, OR 97005 | 2020-06-05 |
| 1346882578 | Mireya Elissa Nunez I | Counselor | 12665 Sw Center Street, Suite 100, Beaverton, OR 97005 | 2019-10-09 |
| 1548816879 | Logan James Patzlaff | Behavior Technician | 6200 Sw Artic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-08-13 |
| 1528521424 | Alex Taylor Foerman | Behavior Technician | 6200 Sw Arctic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-04-09 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1992286348 | Kathryn Wallner | Counselor | 14205 Sw Farmington Road, Suite 160, Beaverton, OR 97005 | 2018-08-23 |
| 1699265058 | Meaghan Mikulic | Social Worker | 14355 Sw Allen Blvd Suite 150, Beaverton, OR 97005 | 2018-05-11 |
| 1629568936 | Aimee J Nelson | Massage Therapist | 10700 Sw Beaverton Hillsdale Hwy Ste 465, Beaverton, OR 97005 | 2018-05-11 |
| 1093221780 | Ember Dahl | Massage Therapist | 12655 Sw Center St Ste 530, Beaverton, OR 97005 | 2017-12-18 |
| 1033667456 | Andre Vo | Pharmacist | 2575 Sw Walker Rd, Beaverton, OR 97005 | 2016-09-14 |
| Find all providers in zip 97005 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of 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 |
|---|---|---|---|---|
| 1295113876 | Cortney Aleese Taylor | Psychiatry & Neurology | 10700 Sw Beaverton Hillsdale Hwy Ste 11, Beaverton, OR 97005-3035 | 2015-05-14 |
| 1770629404 | Robert A. George | Psychiatry & Neurology | 15050 Sw Koll Pkwy, Ste 2a, Beaverton, OR 97006-6001 | 2007-01-29 |
| 1871156968 | Wellpsyche Portland PC | Psychiatry & Neurology | 4145 Sw Watson Ave Ste 350, Beaverton, OR 97005-2191 | 2019-04-15 |
| 1427183839 | Paul M Meyer-strom | Psychiatry & Neurology | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2007-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922481456 | Providence Health & Services - Oregon | Psychiatry & Neurology | 10830 Highway 62, Eagle Point, OR 97524-9516 | 2015-07-01 |
| 1831455211 | Nicholas Austin | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd Dept Of, Portland, OR 97239-3011 | 2012-04-10 |
| 1760773006 | Michelle Elizabeth Feldman | Psychiatry & Neurology | 3876 Beverly Ave Ne Bldg F, Salem, OR 97305-1319 | 2011-04-20 |
| 1235446303 | Ervin Gene Stubbs | Psychiatry & Neurology | 7032 Sw 3rd Ave, Portland, OR 97219-2214 | 2010-09-09 |
| 1851525620 | Sarah Morgan Schrauben | Psychiatry & Neurology | 870 Se 82nd Ave., Portland, OR 97027 | 2009-05-08 |
| 1528249620 | Thomas E Deblois | Psychiatry & Neurology | 133 Ne 8th St, Newport, OR 97365-3130 | 2007-11-16 |
| 1700077328 | Hanh Ngoc Nguyen | Psychiatry & Neurology | 5410 Sw Macadam Ave Ste 200, Portland, OR 97239 | 2007-08-08 |
| 1912116013 | John Barrows Chenoweth | Psychiatry & Neurology | 5410 S.w. Macadam Ave, Ste 200, Portland, OR 97239-3825 | 2007-05-22 |
| 1023238698 | Elliot Morrison | Psychiatry & Neurology | 22025 Ne Butler Market Rd, Bend, OR 97701-9734 | 2007-04-26 |
| 1285852418 | Angelina Montoya | Psychiatry & Neurology | 63360 Britta St, Bldg 1, Bend, OR 97701 | 2007-04-23 |
| Find all providers with the same taxonomy | ||||
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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.