NICHOLAS BEACH (NPI# 1568805786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568805786 |
| Entity Type | Individual |
| Full Name | NICHOLAS BEACH |
| Credential | D.O. |
| Practice Address |
24800 Se Stark St Gresham OR 97030-3378 |
| Mailing Address |
Po Box 3777 Portland OR 97208-3777 |
| Practice Telephone | 5034138407 |
| Practice Fax Number | 5034136951 |
| Mailing Telephone | 5034133900 |
| Mailing Fax Number | 5034133710 |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2016-06-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | DO176517 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
24800 SE STARK ST |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-3378 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033183918 | Amy Katherine Chaumeton | Internal Medicine | 24800 Se Stark St, Gresham, OR 97030-3378 | 2006-02-15 |
| 1154984763 | Devon Heisler | Pharmacy | 24800 Se Stark St, Gresham, OR 97030-3378 | 2019-04-18 |
| 1356806970 | Tyrell Anthony Comeaux | Dietitian, Registered | 24800 Se Stark St, Gresham, OR 97030-3378 | 2019-02-07 |
| 1710490156 | Kathryn Collins | Physical Therapist | 24800 Se Stark St, Gresham, OR 97030-3378 | 2017-11-08 |
| 1467995886 | Traci Mo | Pharmacist | 24800 Se Stark St, Gresham, OR 97030-3378 | 2016-12-02 |
| 1437604279 | Leslie Hoang | Physical Therapist | 24800 Se Stark St, Gresham, OR 97030-3378 | 2016-08-22 |
| 1477926574 | Korina Leclerc | Social Worker | 24800 Se Stark St, Gresham, OR 97030-3378 | 2015-11-11 |
| 1326414202 | Mike (huy) Minh Nguyen | Pharmacist | 24800 Se Stark St, Gresham, OR 97030-3378 | 2015-08-14 |
| 1760878243 | Matthew Sabongi | Internal Medicine | 24800 Se Stark St, Gresham, OR 97030-3378 | 2015-04-10 |
| 1922406362 | Rnfa Assist, LLC | Registered Nurse | 24800 Se Stark St, Gresham, OR 97030-3378 | 2014-12-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 |
|---|---|---|---|---|
| 1376720052 | Shevyll Arvie Siong Tan | Internal Medicine | 24988 Stark. St., Legacy Medical Group Mount Hood, Suite 220 Medical Office Bldg 3, Gresham, OR 97030 | 2008-01-24 |
| 1619173085 | Regina S. Won | Internal Medicine | 24800 Se Stark St Fl 3, Legacy Medicine Inpatient Service, Gresham, OR 97030 | 2007-06-22 |
| 1134204340 | Gresham Internal Medicine Clinic | Internal Medicine | 24900 Se Stark St Ste 109, Gresham, OR 97030-3381 | 2006-10-26 |
| 1952497307 | Maureen Ann Wright | Internal Medicine | 831 Nw Council Dr Ste 125, Gresham, OR 97030-3794 | 2006-10-05 |
| 1730133679 | Sunita M Deshmukh | Internal Medicine | 440 Nw Division St, Gresham, OR 97030-5506 | 2006-05-22 |
| 1033183918 | Amy Katherine Chaumeton | Internal Medicine | 24800 Se Stark St, Gresham, OR 97030-3378 | 2006-02-15 |
| 1770561813 | John M Custis | Internal Medicine | 24900 Se Stark, Ste 109, Gresham, OR 97030 | 2006-01-09 |
| 1972078590 | Portland Adventist Medical Center | Internal Medicine | 831 Nw Council Dr Ste 125, Gresham, OR 97030-3794 | 2018-10-10 |
| 1760878243 | Matthew Sabongi | Internal Medicine | 24800 Se Stark St, Gresham, OR 97030-3378 | 2015-04-10 |
| 1073951208 | Brittney B Mensen | Internal Medicine | 831 Nw Council Dr Ste 101, Gresham, OR 97030-3722 | 2013-06-10 |
| Find all providers in GRESHAM | ||||
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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.