DR. AJAY WANCHU (NPI# 1528295557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528295557 |
| Entity Type | Individual |
| Full Name | DR. AJAY WANCHU |
| Credential | MD |
| Practice Address |
10101 Se Main St Ste 2011 Portland OR 97216-2457 |
| Practice Telephone | 5032616912 |
| Practice Fax Number | 5032516357 |
| Mailing Telephone | 5032616912 |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
MD160711 | OR | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3181 Sw Sam Jackson Park Rd # Op09, Portland, OR 972393011 | 5034948963 | 5034941022 |
| Street Address |
10101 SE MAIN ST STE 2011 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97216-2457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114453099 | Kindra L Thrasher | Dietitian, Registered | 10101 Se Main St Ste 2011, Portland, OR 97216-2457 | 2017-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316468341 | Accident Care Chiropractic and Massage of Salem | Clinic/Center | 2168 Lancaster Dr. Ne, Portland, OR 97216 | 2017-06-29 |
| 1528508520 | Damone Brown | Peer Specialist | 10209 Se Washington St, Suite D, Portland, OR 97216 | 2017-02-24 |
| 1861937237 | Malachai Investments LLC | Clinical Medical Laboratory | 10,000 Se Main St, Ste 360, Portland, OR 97216 | 2016-12-21 |
| 1881136836 | Krista Marie Darnell | Occupational Therapy Assistant | 1475, Se 100th Avenue, Portland, OR 97216 | 2016-11-08 |
| 1821456559 | Sean Kelly | Counselor | 10564 Se Washington Street, Portland, OR 97216 | 2016-02-09 |
| 1174908321 | Phil Bergland | Counselor | 11220 Se Stark St, Suite 6, Portland, OR 97216 | 2015-07-29 |
| 1134507346 | Beth Lopez | Massage Therapist | 5814 Se Stark Street, Portland, OR 97216 | 2015-05-08 |
| 1982081477 | Amelia C Hunt | Counselor | 10564 Se Washinton Street, Portland, OR 97216 | 2015-05-04 |
| 1073907978 | Karen Ta | Emergency Medicine | 10300 Se Main St, Portland, OR 97216 | 2015-03-27 |
| 1265823298 | Laura Catherine Anderson | Occupational Therapist | 1475 Se 100th Avenue, Portland, OR 97216 | 2015-02-12 |
| Find all providers in zip 97216 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023229812 | Sarah Jan Lipton | Internal Medicine | 5050 Ne Hoyt St Ste 155, Portland, OR 97213-2956 | 2007-05-24 |
| 1215035449 | Mollie E Thompson | Internal Medicine | 9155 Sw Barnes Rd Ste 314, Portland, OR 97225-6630 | 2006-09-20 |
| 1144295148 | Richard M Wernick | Internal Medicine | 5050 Ne Hoyt Street, Suite 155, Portland, OR 97213-2956 | 2006-02-22 |
| 1295732261 | Kip L Kemple | Internal Medicine | 2230 Nw Pettygrove, #120, Portland, OR 97210 | 2005-07-05 |
| 1316940075 | John W. Griffin | Internal Medicine | 10101 Se Main St, Ste 2001, Portland, OR 97216-2457 | 2005-05-24 |
| 1902200462 | Theodore Alexander Tsoukas | Internal Medicine | 3181 Sw Sam Jackson Park Road, Portland, OR 97239 | 2014-10-13 |
| 1255607545 | Marcia Alwina Friedman | Internal Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2012-03-30 |
| 1194014530 | Julianna Desmarais | Internal Medicine | 3181 Sw Sam Jackson Park Rd, Mail Code Op09, Portland, OR 97239-3011 | 2011-04-06 |
| 1679862759 | Neha Rich-garg | Internal Medicine | 9155 Sw Barnes Rd, #314, Portland, OR 97225-6625 | 2011-03-29 |
| 1306015995 | Jennifer Lynn Barton | Internal Medicine | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2008-02-27 |
| 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.