ADVANTAGE ORTHOPEDIC AND SPORTS MEDICINE CLINIC LLP (NPI# 1598798365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598798365 |
| Entity Type | Organization |
| Organization Name | ADVANTAGE ORTHOPEDIC AND SPORTS MEDICINE CLINIC LLP |
| Practice Address |
24076 Se Stark Suite 110 Gresham OR 97030-3374 |
| Practice Telephone | 5036615388 |
| Practice Fax Number | 5036669393 |
| Mailing Telephone | 5036615388 |
| Mailing Fax Number | 5036669393 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2015-04-09 |
| Authorized Official Name | MS. HEIDI HOXSIE (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 5036615388 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ADVANTAGE ORTHOPEDIC AND SPORTS MEDICINE CLINIC LLP | 24076 Se Stark Ste 110, Gresham, OR 97030 |
| Street Address |
24076 SE STARK SUITE 110 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030-3374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225017783 | Marc Romayne Davidson | Orthopaedic Surgery | 24076 Se Stark, Ste 110, Gresham, OR 97030 | 2006-01-12 |
| 1477533966 | Jeffreys D Albright | Orthopaedic Surgery | 24076 Se Stark, Suite 110, Gresham, OR 97030 | 2006-01-19 |
| 1386624872 | Bret Hardin Dales | Orthopaedic Surgery | 24076 Se Stark, Suite 110, Gresham, OR 97030 | 2006-01-19 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639727795 | Christina Bellmore | Specialist | 1748 Nw Fairview Dr # A, Gresham, OR 97030-3842 | 2019-08-30 |
| 1952795494 | Angela Goble | Specialist | 4010 Sw 14th Dr, Gresham, OR 97080-8373 | 2015-03-23 |
| 1568869097 | Michelle Meadow | Specialist | 124 Sw 6th Ct, Gresham, OR 97080-9390 | 2014-11-26 |
| 1235534504 | Lisa Barrow | Specialist | 1277 Ne 14th Ln, Gresham, OR 97030-4218 | 2014-10-29 |
| 1962828848 | Colleen Duncan | Specialist | 223 E Powell Blvd, Gresham, OR 97030-7605 | 2014-03-14 |
| 1558657049 | Zara Michelle Parker | Specialist | 4170 Ne El Camino Dr, Gresham, OR 97030-1749 | 2011-06-22 |
| 1194942920 | Salomeia Stan | Specialist | 655 Nw Burnside Rd, Suite 6, Gresham, OR 97030-3745 | 2007-04-20 |
| 1528198306 | Kimberly Anne Fuller | Specialist | 1217 Ne Burnside Rd Ste 502, Gresham, OR 97030-5770 | 2007-03-07 |
| 1114066214 | Amber Buxton | Specialist | 22011 Se Oak St, Gresham, OR 97030-8509 | 2007-02-05 |
| 1437217478 | Kendall Kay-lynn Hutchinson | Specialist | 231 N Main Ave, Gresham, OR 97030-7207 | 2006-12-04 |
| Find all providers in GRESHAM | ||||
Please comment or provide details below to improve the information on ADVANTAGE ORTHOPEDIC AND SPORTS MEDICINE CLINIC LLP.
| 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.