DOUGLAS PETERS (NPI# 1568810638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568810638 |
| Entity Type | Individual |
| Full Name | DOUGLAS PETERS |
| Practice Address |
2730 Sw Moody Ave Cl5pa Portland OR 97201-5042 |
| Mailing Address |
2800 S Texas Ave Ste 202 Bryan TX 77802-5361 |
| Practice Telephone | 5034943633 |
| Mailing Telephone | 9797742053 |
| Mailing Fax Number | 9797765914 |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2018-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA11732 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437421930 | Douglas Peters | Pharmacist | 1143 Broad St, Sumter, SC 29150-1971 | 2012-01-31 |
| 1548413503 | Douglas Ahern Peters | Internal Medicine | 255 Glendale Ave., Suite 12, Sparks, NV 89431 | 2008-11-03 |
| 1780824102 | Douglas J. Peters | Physician Assistant | 1638 Owen Dr, Fayetteville, NC 28304-3424 | 2009-02-25 |
| 1447452289 | Douglas Richard Peters | Physical Therapist | 4600 38th St, Columbus, NE 68601-1664 | 2007-06-04 |
| 1528134343 | Douglas W Peters | Family Medicine | 1201 W Agency Rd, West Burlington, IA 52655-1645 | 2006-11-24 |
| 1174567663 | Douglas Knox Peters | Family Medicine | 6360 W Sam Houston Pkwy N, Ste 200, Houston, TX 77041 | 2006-06-15 |
| Street Address |
2730 SW MOODY AVE CL5PA |
| City | PORTLAND |
| State | OR |
| Zip Code | 97201-5042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942206313 | Kerrie Lee Shirley | Pharmacist | 2730 Sw Moody Ave, Pmb 260, Portland, OR 97201 | 2005-06-21 |
| 1154943116 | Yves Gacinya | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-13 |
| 1427670660 | Claudemir Da Silva Lima | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-11 |
| 1639791726 | An Ruan | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-11 |
| 1437771904 | Lucia Novak | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-07 |
| 1881215358 | Donald Alfred Defrang II | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-06 |
| 1992326573 | Mirah-aizza Galuego | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-05 |
| 1063033819 | Kelsey Moore | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-04 |
| 1164043972 | Andrew Henderson | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-04 |
| 1225659006 | Thomas Peckenham-hernandez | Student in an Organized Health Care Education/Training Program | 2730 Sw Moody Ave, Portland, OR 97201-5042 | 2020-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206060 | Laura Elizabeth Jackson | Student in an Organized Health Care Education/Training Program | 2730 S Moody Ave, Portland, OR 97201 | 2020-05-10 |
| 1225659063 | Amanpreet Kaur | Student in an Organized Health Care Education/Training Program | Ohsu Physician Assistant Program, 2730 South Moody Ave. Mail Code: Cl5pa, Portland, OR 97201 | 2020-05-04 |
| 1063033801 | Aaron Kinn | Student in an Organized Health Care Education/Training Program | Ohsu Division of Physician Assistant Education - Cl5pa, 2730 Sw Moody Avenue, Portland, OR 97201 | 2020-05-04 |
| 1487275442 | Erin Aleen Ostlie-madden | Student in an Organized Health Care Education/Training Program | 2730 South Moody Ave, Portland, OR 97201 | 2020-04-30 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1740825587 | Dalia Bayaa | Pharmacist | 325 Sw Harrison Street, Portland, OR 97201 | 2019-11-15 |
| 1780172619 | Susan Elizabeth Christian Barrios | Social Worker | 1505 Sw College St, Portland, OR 97201 | 2018-04-26 |
| 1730696576 | Fiona Everett | Counselor | 1703 Sw Clay St, Portland, OR 97201 | 2018-01-02 |
| 1437678844 | Akira Thomas Neilsen | Student in an Organized Health Care Education/Training Program | 1930 Sw River Drive, Unit 102, Portland, OR 97201 | 2017-09-18 |
| 1285171736 | Howard Mitchell | Technician, Other | 1110 Sw Clay Street Apt. 34, Portland, OR 97201 | 2017-01-23 |
| Find all providers in zip 97201 | ||||
| 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 | ||||
Please comment or provide details below to improve the information on DOUGLAS PETERS.
| 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.