NORTHWEST RENAL CLINIC, INC. (NPI# 1689117087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689117087 |
Entity Type | Organization |
Organization Name | NORTHWEST RENAL CLINIC, INC. |
Practice Address |
12550 Se 93rd Ave Suite 250 Clackamas OR 97015-9786 |
Practice Telephone | 5036541153 |
Practice Fax Number | 5036547693 |
Mailing Telephone | 5036541153 |
Mailing Fax Number | 5036547693 |
Enumeration Date | 2016-12-02 |
Last Update Date | 2017-08-01 |
Authorized Official Name | JULIE E. TANK (PHYSICIAN) |
Authorized Official Telephone | 5032297976 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396378717 | Northwest Renal Clinic, Inc. | Internal Medicine | 925 Commercial St Se Ste 110, Salem, OR 97302-4172 | 2020-02-13 |
1164946984 | Northwest Renal Clinic, Inc. | Clinic/Center | 9701 Sw Barnes Rd Ste 110, Portland, OR 97225-6774 | 2017-08-02 |
1396924999 | Northwest Renal Clinic, Inc. | Internal Medicine | 9701 Sw Barnes Road, Suite 110, Portland, OR 97225 | 2007-10-31 |
1780228544 | Northwest Renal Clinic, Inc. | Internal Medicine | 105 Maui Lani Pkwy Ste 100, Wailuku, HI 96793-2443 | 2019-11-04 |
1750748901 | Northwest Renal Clinic, Inc. | Internal Medicine | 730 Se Oak St, Suite I, Hillsboro, OR 97123-4245 | 2016-01-19 |
1861700130 | Northwest Renal Clinic, Inc. | Internal Medicine | 10201 Se Main St, Suite 27, Portland, OR 97216-2937 | 2010-09-20 |
1982931333 | Northwest Renal Clinic, Inc. | Internal Medicine | 5050 Ne Hoyt St, Suite B-54, Portland, OR 97213-2991 | 2009-11-05 |
1780865642 | Northwest Renal Clinic, Inc. | Internal Medicine | 9155 Sw Barnes Rd, Suite 402, Portland, OR 97225-6625 | 2007-11-20 |
1679752273 | Northwest Renal Clinic, Inc. | Internal Medicine | 8050 Sw Warm Springs St, Suite 150, Tualatin, OR 97062-7424 | 2007-10-31 |
1528036662 | Northwest Renal Clinic, Inc. | Internal Medicine | 1130 Nw 22nd Ave, Ste 640, Portland, OR 97210-2993 | 2006-03-14 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | NORTHWEST RENAL CLINIC, INC. | 1130 Nw 22nd #640, Portland, OR 97210 |
Street Address |
12550 SE 93RD AVE SUITE 250 |
City | CLACKAMAS |
State | OR |
Zip Code | 97015-9786 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417939364 | Mark Newell Mccurdy | Physical Therapist | 12550 Se 93rd Ave, Ste 265, Clackamas, OR 97015-8796 | 2005-11-16 |
1841744323 | Ashley Billingsley | Physical Therapist | 12550 Se 93rd Ave, Site 265, Clackamas, OR 97015-9786 | 2016-08-12 |
1477885218 | James Alexander Novotny | Nurse Practitioner | 12550 Se 93rd Ave, Suite 250, Clackamas, OR 97015-9786 | 2010-02-04 |
1720058530 | Julie Michelle Larson | Physical Therapist | 12550 Se 93rd Ave, Ste 265, Clackamas, OR 97015-9786 | 2006-01-24 |
1851377212 | Therapeutic Associates Inc | Physical Therapist | 12550 Se 93rd Ave, Ste 265, Clackamas, OR 97015-9786 | 2005-12-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
Find all providers in zip 97015 |
Taxonomy Code | 207RN0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Nephrology |
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
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 |
---|---|---|---|---|
1396378717 | Northwest Renal Clinic, Inc. | Internal Medicine | 925 Commercial St Se Ste 110, Salem, OR 97302-4172 | 2020-02-13 |
1477962694 | Centennial Medical Group Inc. | Internal Medicine | 2460 Nw Stewart Pkwy Ste 102, Roseburg, OR 97471-1516 | 2014-08-13 |
1528487527 | Janie Luong | Internal Medicine | 10201 Se Main St Ste 27, Portland, OR 97216-2937 | 2014-04-08 |
1386074953 | David Alan Mccarron | Internal Medicine | 120 Nw 9th Ave, Suite 206, Portland, OR 97209-3324 | 2013-11-19 |
1578859849 | Thuy Xuan Le | Internal Medicine | 1040 Nw 22nd Ave Ste 480, Portland, OR 97210-3062 | 2011-06-24 |
1427348150 | Mark Nguyen | Internal Medicine | 1130 Nw 22nd Ave Ste 640, Portland, OR 97210-2993 | 2011-04-14 |
1720377039 | Robert Whitney Rope | Internal Medicine | 3181 Sw Sam Jackson Park Rd Mc Sjh6, Portland, OR 97239-3011 | 2011-04-07 |
1578707451 | Kate Schoolwerth Gustafson | Internal Medicine | 3710 Sw Us Veterans Hospital Rd # P3neph, Portland, OR 97239-2964 | 2009-04-23 |
1174777973 | Tricia Noelle Jesperson | Internal Medicine | 5050 Ne Hoyt St Ste B54, Portland, OR 97213 | 2008-11-06 |
1861677825 | Apolonia G. Silva | Internal Medicine | 6736 Ne Killingsworth Street La Clinica De Buena Salud, Portland, OR 97218-3338 | 2008-01-08 |
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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.