CLIFTON A. J. EDWARDS (NPI# 1760856231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760856231 |
| Entity Type | Individual |
| Full Name | CLIFTON A. J. EDWARDS |
| Credential | MHA,REEGT,PMP, CPHQ |
| Practice Address |
3347 Ne 164th Loop Portland OR 97230-5063 |
| Mailing Address |
3439 Ne Sandy Blvd # 367 Portland OR 97232-1959 |
| Practice Telephone | 9712279340 |
| Mailing Telephone | 9712279340 |
| Mailing Fax Number | 8643645280 |
| Enumeration Date | 2015-11-21 |
| Last Update Date | 2017-02-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246Z00000X | Specialist/Technologist, Other | #3726: RPSGT | Technologists, Technicians & Other Technical Service Providers | |
| N | 246Z00000X | Specialist/Technologist, Other | #847: R. EP T. | Technologists, Technicians & Other Technical Service Providers | |
| Y | 246ZE0500X |
Specialist/Technologist, Other Specialization: EEG |
#3283: R. EEG T. | Technologists, Technicians & Other Technical Service Providers | |
| N | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568998128 | Clifton Edwards | Behavior Technician | 500 Fairway Dr, Suite 102, Deerfield Beach, FL 33441-1814 | 2017-05-02 |
| Street Address |
3347 NE 164TH LOOP |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-5063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687233 | Timisha K Wilson | Social Worker | 12505 Ne Halsey St, Portland, OR 97230 | 2018-07-30 |
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1063937951 | Marley Elizabeth Small | Counselor | 1507 Ne 122nd Ave., Portland, OR 97230 | 2017-08-11 |
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1649622473 | Sara Mcgroarty | Counselor | 17710 Ne Halsey Street, Portland, OR 97230 | 2016-07-05 |
| 1346699949 | Steven D Stanton | Counselor | 1022 Ne 181st Ave, C1, Portland, OR 97230 | 2016-06-06 |
| 1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
| Find all providers in zip 97230 | ||||
| Taxonomy Code | 246ZE0500X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | EEG |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265896955 | In Home Neuro Studies LLC | Specialist/Technologist, Other | 3349 N.e. Sandy Blvd., # 367, Portland, OR 97232-1959 | 2016-04-08 |
| 1700127941 | Lifetime Optimization, Inc. | Specialist/Technologist, Other | 6105 Sw Macadam Ave Ste 100, Portland, OR 97239-3640 | 2013-03-13 |
Please comment or provide details below to improve the information on CLIFTON A. J. EDWARDS.
| 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.