JOSEPH PROVINCE (NPI# 1558797365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558797365 |
Entity Type | Individual |
Full Name | JOSEPH PROVINCE |
Credential | PA |
Practice Address |
10000 Se Main St Ste 224 Portland OR 97216-2469 |
Mailing Address |
10000 Se Main Street Suite 224 Portland OR 97216 |
Practice Telephone | 5032616961 |
Practice Fax Number | 5032616959 |
Mailing Telephone | 5032616961 |
Enumeration Date | 2013-09-25 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA182241 | OR | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9107470 | FL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 010158600 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
2531 Cleveland Ave Ste 1, Fort Myers, FL 339014900 | 2393347000 | 2393347070 |
Street Address |
10000 SE MAIN ST STE 224 |
City | PORTLAND |
State | OR |
Zip Code | 97216-2469 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437174489 | Andrea J Young | Orthopaedic Surgery | 10000 Se Main St Ste 224, Portland, OR 97216-2469 | 2006-07-12 |
1639688708 | Wesley Wenzel | Physician Assistant | 10000 Se Main St Ste 224, Portland, OR 97216-2469 | 2017-09-21 |
1578982567 | Elizabeth Gray Lieberman | Orthopaedic Surgery | 10000 Se Main St Ste 224, Portland, OR 97216-2469 | 2014-04-07 |
1003121849 | Cory Vernon Carlston | Orthopaedic Surgery | 10000 Se Main St Ste 224, Portland, OR 97216-2469 | 2010-08-17 |
1558533273 | Adam Parks Baker | Orthopaedic Surgery | 10000 Se Main St Ste 224, Portland, OR 97216-2469 | 2008-04-02 |
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 | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
1396250122 | Saron Theresa Sufuentes | Physician Assistant | 578 Nw Marlborough Ave, Portland, OR 97210-3104 | 2017-12-01 |
1952775520 | Lauren Govier | Physician Assistant | 501 N Graham St Ste 415, Portland, OR 97227-2006 | 2015-11-19 |
1619346368 | Ryan Mcmahon | Physician Assistant | 3415 Ne 20th Ave, Portland, OR 97212-2416 | 2015-09-23 |
1881090033 | Sanja Bukarac | Physician Assistant | 20 Buca Run, Portland, ME 04103-1427 | 2014-11-17 |
1194130716 | Nicole Lessard | Physician Assistant | 27 Bramhall St, Portland, ME 04102 | 2014-06-23 |
1528499910 | Elan Kennedy | Physician Assistant | 3181 Sw Sam Jackson Park Rd., Mail Code L353, Ohsu, Division of Cardiothoracic Surgery, Portland, OR 97239 | 2013-12-10 |
1013161405 | Lorraine Walburga Gohman | Physician Assistant | 9155 Sw Barnes Rd Ste 440, Portland, OR 97225-6631 | 2008-11-11 |
1841472065 | Mandy Melissa Williams | Physician Assistant | 265 N Broadway, Portland, OR 97227-1800 | 2007-11-29 |
1063612455 | Donald R Noel | Physician Assistant | 10101 Se Main St Ste 3008, Portland, OR 97216-2458 | 2007-07-23 |
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.