BROADWAY MEDICAL CLINIC LLP (NPI# 1720082316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1720082316 |
Entity Type | Organization |
Organization Name | BROADWAY MEDICAL CLINIC LLP |
Practice Address |
4212 Ne Broadway St Portland OR 97213-1460 |
Practice Telephone | 5032498787 |
Practice Fax Number | 5032845168 |
Mailing Telephone | 5032498787 |
Mailing Fax Number | 5032845168 |
Enumeration Date | 2005-06-10 |
Last Update Date | 2020-02-12 |
Authorized Official Name | CANDY S CHAPMAN (ADMINISTRATOR) |
Authorized Official Telephone | 5033317650 |
Authorized Official Credential | CMPE |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
========= | OR | Ambulatory Health Care Facilities |
Street Address |
4212 NE BROADWAY ST |
City | PORTLAND |
State | OR |
Zip Code | 97213-1460 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841427572 | Michael Mazzotta | Internal Medicine | 4212 Ne Broadway St, Medical Staff Svcs, Portland, OR 97213-1422 | 2009-06-21 |
1487896403 | Emily Wasser Puterbaugh | Pediatrics | 4212 Ne Broadway St, Portland, OR 97213-1422 | 2009-04-06 |
1629275508 | Melissa Ann Hahn | Pediatrics | 4212 Ne Broadway St, Portland, OR 97213-1422 | 2007-07-02 |
1306964911 | Patricia Sandstrom Burke | Pediatrics | 4212 Ne Broadway St, Portland, OR 97213-1422 | 2007-03-26 |
1164563185 | Susan Frances Calvert | Pharmacist | 4212 Ne Broadway St, Portland, OR 97213-1460 | 2007-02-11 |
1073670832 | Mary Baker | Pediatrics | 4212 Ne Broadway St, Portland, OR 97213-1460 | 2007-01-02 |
1902961907 | Charles M Wood | Internal Medicine | 4212 Ne Broadway St, Portland, OR 97213-1422 | 2006-12-27 |
1407916513 | Anne M Hirsch | Internal Medicine | 4212 Ne Broadway St, Portland, OR 97213-1460 | 2006-12-11 |
1568539195 | Douglas E Renouard | Internal Medicine | 4212 Ne Broadway St, Portland, OR 97213-1460 | 2006-11-29 |
1013084573 | Luis A Valls | Internal Medicine | 4212 Ne Broadway St, Portland, OR 97213-1460 | 2006-11-29 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
Find all providers in zip 97213 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104447895 | Beyond Health LLC | Clinic/Center | 6440 Nw Mcmullen Ave, Portland, OR 97229-1158 | 2020-05-04 |
1831757475 | Structural Solutions Chiropractic | Clinic/Center | 121 Nw Everett St, Portland, OR 97209-4049 | 2019-05-29 |
1033674841 | Jeremy Mikolai Nd Inc | Clinic/Center | 2540 Ne M L King Blvd, Portland, OR 97212-3732 | 2019-02-06 |
1326531666 | Working Class Medicine LLC | Clinic/Center | 2133 N. Willis Blvd, Studio D, Portland, OR 97217 | 2018-06-12 |
1023511698 | Housecall Md LLC | Clinic/Center | 3715 Sw Marquam Hill Rd, Portland, OR 97239-1454 | 2018-03-09 |
1053859959 | Vera Whole Health | Clinic/Center | 400 Sw 6th Ave, Suite 915, Portland, OR 97204-1628 | 2017-02-10 |
1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
1154725224 | Thriving Force, LLC | Clinic/Center | 4426 Ne 35th Ave, Portland, OR 97211-7735 | 2014-10-17 |
1679981070 | Roots Health Clinic LLC | Clinic/Center | 330 Ne 102nd Ave, Portland, OR 97220-4107 | 2014-07-29 |
1558792309 | North By Northeast Community Health Center | Clinic/Center | 3030 Ne Martin Luther King Jr Blvd, Portland, OR 97212-3053 | 2013-12-04 |
Find all providers in PORTLAND |
Please comment or provide details below to improve the information on BROADWAY MEDICAL 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.