DONALD W. FORTLAGE (NPI# 1659369304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659369304 |
| Entity Type | Individual |
| Full Name | DONALD W. FORTLAGE |
| Other Name | DR. DONALD W FORTLAGE |
| Practice Address |
10202 Se 32nd Ave Suite 201 Milwaukie OR 97222-3610 |
| Practice Telephone | 5036530770 |
| Practice Fax Number | 5036530844 |
| Mailing Telephone | 5036530770 |
| Mailing Fax Number | 5036530844 |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | MD00021724 | WA | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | MD07219 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | GOOD HEALTH PLAN | D95253000001 | 01 |
| OR | 062844 | 05 |
| Street Address |
10202 SE 32ND AVE SUITE 201 |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97222-3610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396149225 | Providence Health & Services - Oregon | Dermatology | 10202 Se 32nd Ave, Suite 702, Milwaukie, OR 97222-3625 | 2014-10-21 |
| 1225346661 | Justin David Galasso | Social Worker | 10202 Se 32nd Ave, Milwaukie, OR 97222-3610 | 2010-09-20 |
| 1407177934 | Oregon Cosmetic and Reconstructive Clinic, PC | Plastic Surgery | 10202 Se 32nd Ave, Suite 702, Milwaukie, OR 97222-3610 | 2010-06-18 |
| 1306077896 | Jonathan Reece Walker | Counselor | 10202 Se 32nd Ave, 504, Milwaukie, OR 97222-3610 | 2009-07-31 |
| 1225271133 | Milwaukie Orthopedic Service Inc | Orthopaedic Surgery | 10202 Se 32nd Ave, Suite 101, Milwaukie, OR 97222-3610 | 2009-04-08 |
| 1700079506 | Michael Thomas Dotter | Pharmacist | 10202 Se 32nd Ave, Suite 701, Milwaukie, OR 97222-3610 | 2007-08-24 |
| 1578765335 | Mihai Daniel Onofrei | Pharmacist | 10202 Se 32nd Ave, Suite 701, Milwaukie, OR 97222-3610 | 2007-06-04 |
| 1912128935 | Teresa Marie Maddalone Swift | Pharmacist | 10202 Se 32nd Ave, Milwaukie, OR 97222-3610 | 2007-05-01 |
| 1679793327 | John B Hardiman, Md Inc | Orthopaedic Surgery | 10202 Se 32nd Ave, Suite 101, Milwaukie, OR 97222-3610 | 2007-04-26 |
| 1164642831 | John Hardiman | Orthopaedic Surgery | 10202 Se 32nd Ave, Suite 101, Milwaukie, OR 97222-3610 | 2007-04-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
| 1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
| 1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
| 1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
| 1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
| 1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
| 1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
| 1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
| Find all providers in zip 97222 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841380375 | Lisa C. Sullivan | Pediatrics | 4950 Se Roethe Rd, Milwaukie, OR 97267-5746 | 2006-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114558368 | Oregon Pediatrics-oregon City, PC | Pediatrics | 1510 Division St Ste 80, Oregon City, OR 97045-1572 | 2020-01-27 |
| 1962911347 | Bend Kids Pediatrics, LLC | Pediatrics | 2748 Nw Crossing Dr Ste 140, Bend, OR 97703-7179 | 2017-09-28 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1235660176 | Erik Grimm | Pediatrics | 16463 Boones Ferry Rd Ste 400, Lake Oswego, OR 97035-4377 | 2017-03-22 |
| 1891178885 | Snake River Pediatrics | Pediatrics | 1050 Sw 3rd Ave Ste 3200, Ontario, OR 97914-4560 | 2015-07-08 |
| 1447663810 | Anh Linh Hoang | Pediatrics | 9243 Ne Glisan St, Portland, OR 97220-4533 | 2014-06-03 |
| 1891126538 | Sydmarie Bisenius | Pediatrics | 24850 Se Stark St Ste 150, Gresham, OR 97030-8318 | 2013-12-05 |
| 1427499367 | Elizabeth Bish Young | Pediatrics | 901 Bellwood Ln, Roseburg, OR 97471-9299 | 2013-07-08 |
| 1255771671 | Steven Donald Mcgaughey | Pediatrics | Ohsu Doernbecher, 3181 Sw Sam Jackson Park Road, Portland, OR 97239-1002 | 2013-06-29 |
| 1508109539 | Ramya Mishra Jariwala | Pediatrics | 9155 Sw Barnes Rd Ste 840, Portland, OR 97225 | 2013-03-28 |
| Find all providers with the same taxonomy | ||||
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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.