MEGAN LEAR MUDRICK (NPI# 1528250131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528250131 |
| Entity Type | Individual |
| Full Name | MEGAN LEAR MUDRICK |
| Other Name | MEGAN ELIZABETH LEAR |
| Credential | MD |
| Practice Address |
417 Sw 117th Ave Suite 100 Portland OR 97225-5924 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032161800 |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2015-10-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD164511 | OR | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 04-34032 | KS | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 0101243296 | VA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 036118322 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500676578 | 05 | |
| VA | 1528250131 | 05 |
| Street Address |
417 SW 117TH AVE SUITE 100 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588666432 | Myrna Antonio Casono | Internal Medicine | 417 Sw 117th Ave, Portland, OR 97225-5924 | 2005-08-11 |
| 1871065649 | Kathryn Elise Burk | Physician Assistant | 417 Sw 117th Ave, Portland, OR 97225-5924 | 2018-12-18 |
| 1447736608 | Jonathan Ryan Fordyce | Nurse Practitioner | 417 Sw 117th Ave, Portland, OR 97225-5924 | 2018-07-11 |
| 1609206036 | Nicole Knigge | Physician Assistant | 417 Sw 117th Ave, 2nd Floor, Portland, OR 97225-5924 | 2013-11-21 |
| 1669801387 | Karen Ann Ballard | Nurse Practitioner | 417 Sw 117th Ave, Suite 100, Portland, OR 97225-5924 | 2013-11-04 |
| 1043648330 | Yvonne Howell | Physician Assistant | 417 Sw 117th Ave, Suite 200, Portland, OR 97225-5924 | 2013-10-23 |
| 1346450319 | Jean D Lee | Internal Medicine | 417 Sw 117th Ave, 2nd Floor, Portland, OR 97225-5924 | 2007-05-22 |
| 1376680918 | Connie Volpi | Physician Assistant | 417 Sw 117th Ave, 2nd Floor, Portland, OR 97225-5924 | 2007-01-31 |
| 1154408151 | Michael R. Mcclung Md | Clinic/Center | 417 Sw 117th Ave, Ste. 120, Portland, OR 97225-5924 | 2006-11-01 |
| 1083714141 | Providence Health & Services - Oregon | Clinic/Center | 417 Sw 117th Ave, 2nd Floor, Portland, OR 97225-5924 | 2006-09-25 |
| 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 | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639710783 | Christine Elizabeth O'connor | Family Medicine | 6336 Se 61st Ave, Portland, OR 97206-6718 | 2019-09-30 |
| 1427608645 | Carehere LLC | Family Medicine | Carehere Clinic- Nasg Portland, Tn, 160 Kirby Drive, Portland, TN 37148 | 2019-09-19 |
| 1063064285 | Victoria A Deane | Family Medicine | 37 Fall Brook St, Portland, ME 04103-4224 | 2019-07-09 |
| 1598238214 | Whole Systems Healthcare | Family Medicine | 1020 Sw Taylor St Ste 340, Portland, OR 97205-2508 | 2019-01-04 |
| 1770089245 | Richard Farwell Leman | Family Medicine | 800 Ne Oregon St., Suite 772, Portland, OR 97232 | 2018-04-03 |
| 1952803413 | Aleksandra Giedowyn Md PC | Family Medicine | 1923 Ne Broadway Street Suite 2, Portland, OR 97232 | 2018-03-01 |
| 1871943159 | Micah Kiehl | Family Medicine | 4427 Ne Fremont St, Portland, OR 97213-1153 | 2016-06-16 |
| 1083068589 | Carrie Lynn Binder | Family Medicine | 1035 Nw Northrup St, Portland, OR 97209-3017 | 2016-04-20 |
| 1437513835 | Kayce A Spear | Family Medicine | 10803 Se Cherry Blossom Drive, Portland, OR 97216-3107 | 2016-04-12 |
| 1992175509 | Lone Star Evaluations Inc. | Family Medicine | 1500 Wildcat Dr Ste M, Portland, TX 78374-2826 | 2015-09-25 |
| 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.