DR. MYRNA ANTONIO CASONO (NPI# 1588666432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588666432 |
| Entity Type | Individual |
| Full Name | DR. MYRNA ANTONIO CASONO |
| Credential | MD |
| Practice Address |
417 Sw 117th Ave Portland OR 97225-5924 |
| Mailing Address |
7947 Sw Leiser Ln Tigard OR 97224-7401 |
| Practice Telephone | 5032169400 |
| Mailing Telephone | 5033036906 |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2019-06-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 17939 | NV | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 13598 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | NV STATE LICENSE | 17939 | 01 |
| NV | 1588666432 | 05 |
| Street Address |
417 SW 117TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1528250131 | Megan Lear Mudrick | Family Medicine | 417 Sw 117th Ave, Suite 100, Portland, OR 97225-5924 | 2007-08-16 |
| 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 | 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 |
|---|---|---|---|---|
| 1770107302 | Vpa PC | Internal Medicine | 1500 Ne 15th Ave Apt 431, Portland, OR 97232-4418 | 2020-05-29 |
| 1073167730 | Oregon Adult Medicine PC | Internal Medicine | 2330 Nw Flanders St Ste 201, Portland, OR 97210-3460 | 2019-07-30 |
| 1265889265 | Jared Tobolski | Internal Medicine | 22 Bramhall St Dept Of, Portland, ME 04102-3175 | 2016-05-19 |
| 1528421039 | Celine Haotian Zhou | Internal Medicine | 3181 Sw Sam Jackson Park Rd, L-579, Ohsu, Portland, OR 97239 | 2016-04-01 |
| 1043685407 | Michael David Fox | Internal Medicine | 1015 Nw 22nd Ave # 230, Portland, OR 97210-3025 | 2015-12-09 |
| 1134516701 | Anne Longtine | Internal Medicine | 65 Waterville St, Portland, ME 04101 | 2015-04-22 |
| 1184016099 | Wendy W Yu | Internal Medicine | 9135 Sw Barnes Rd Ste 763, Portland, OR 97225-6777 | 2015-03-02 |
| 1639586191 | Stefan Christison | Internal Medicine | 1120 Nw 20th Ave Ste 110, Portland, OR 97209-1591 | 2014-07-16 |
| 1336551555 | Lee Michael Anthony | Internal Medicine | 9205 Sw Barnes Rd Mt-2800, Portland, OR 97225-6603 | 2014-05-22 |
| 1558772889 | Kyaw Zin Thein | Internal Medicine | 3485 S Bond Ave, Portland, OR 97239-4503 | 2014-05-08 |
| 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.