CARLEY PUTNAM (NPI# 1649782699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649782699 |
| Entity Type | Individual |
| Full Name | CARLEY PUTNAM |
| Credential | PA-C |
| Practice Address |
3303 Sw Bond Ave Ste 5 Portland OR 97239-4501 |
| Mailing Address |
1650 Nw Naito Pkwy Ste 185 Portland OR 97209-2535 |
| Practice Telephone | 5034946687 |
| Practice Fax Number | 5034941717 |
| Mailing Telephone | 5035257658 |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2019-09-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA187398 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2850 Se Powell Valley Rd, Gresham, OR 97080 | 5036665050 | 5036661162 |
| Street Address |
3303 SW BOND AVE STE 5 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710140215 | Shiliang Chang | Plastic Surgery | 3303 Sw Bond Ave Ste 5, Portland, OR 97239-4501 | 2008-07-03 |
| 1669914305 | Michelle Rose Cappadona | Specialist | 3303 Sw Bond Ave Ste 5, Portland, OR 97239-4501 | 2016-11-11 |
| 1356744833 | Laura Winter Dillon | Physician Assistant | 3303 Sw Bond Ave Ste 5, Portland, OR 97239-4501 | 2014-09-29 |
| 1952672289 | David Sining Chen | Otolaryngology | 3303 Sw Bond Ave Ste 5, Portland, OR 97239-4501 | 2012-01-18 |
| 1649581562 | Jens Urs Berli | Plastic Surgery | 3303 Sw Bond Ave Ste 5, Portland, OR 97239-4501 | 2010-06-24 |
| 1457677478 | Mathew Nate Geltzeiler | Otolaryngology | 3303 Sw Bond Ave Ste 5, Portland, OR 97239-4501 | 2010-04-15 |
| 1891019428 | Angelo B Lipira | Plastic Surgery | 3303 Sw Bond Ave Ste 5, Portland, OR 97239-4501 | 2010-03-25 |
| 1992955090 | Lori Kathryn Howell | Otolaryngology | 3303 Sw Bond Ave Ste 5, Portland, OR 97239-4501 | 2008-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| 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.