US COAST GUARD MEDICAL CLINIC NORTH BEND (NPI# 1770608424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770608424 |
| Entity Type | Organization |
| Organization Name | US COAST GUARD MEDICAL CLINIC NORTH BEND |
| Practice Address |
2000 Connecticut Ave North Bend OR 97459-2300 |
| Practice Telephone | 5417569234 |
| Practice Fax Number | 5417569617 |
| Mailing Telephone | 5417569234 |
| Mailing Fax Number | 5417569617 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. STEPHEN J KINSLEY (SENIOR MEDICAL OFFICER) |
| Authorized Official Telephone | 5417569237 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | 35057309 | OH | Other Service Providers |
| Street Address |
2000 CONNECTICUT AVE |
| City | NORTH BEND |
| State | OR |
| Zip Code | 97459-2300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851472542 | Scott Paul Heverly | Technician, Other | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2006-10-18 |
| 1528423522 | Jaclyn Carricato | Military Health Care Provider | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2015-12-18 |
| 1639534605 | Paul Woodhead | Military Health Care Provider | 2000 Connecticut Ave, Sector North Bend Medical, North Bend, OR 97459-2300 | 2015-12-17 |
| 1659755114 | Tyler Palinkas | Technician, Other | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2015-07-15 |
| 1063832111 | Megan Lucas | Registered Nurse | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2014-04-16 |
| 1992141774 | Dustin W King | Technician, Other | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2013-05-20 |
| 1215202387 | Jonna Marie Emineth | Technician, Health Information | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2012-03-21 |
| 1033416581 | Emmanuel Lopez | Technician, Other | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2011-02-18 |
| 1932430972 | Iredell Camuel Wyatt Iv | Technician, Other | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2010-01-14 |
| 1033395520 | Donna D Tomlinson | Registered Nurse | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2008-01-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568002749 | Ya-chi Claire Chang | Nurse Practitioner | 1229 1890 Waite St #1, North Bend, OR 97459 | 2020-01-15 |
| 1629573977 | Heather M Coates | Counselor | 400 Virginia Ave Ste 100, North Bend, OR 97459 | 2018-03-28 |
| 1205257219 | Melissa Sperry | Health Educator | 510 Lockhart Street, North Bend, OR 97459 | 2013-12-17 |
| 1265862627 | Elizabeth Sylvester | Counselor | 1592 Monroe Street, North Bend, OR 97459 | 2013-11-22 |
| 1124370291 | Brian Noble Thompson | Pharmacist | 3411 Broadway St., North Bend, OR 97459 | 2012-10-12 |
| 1295081230 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3411 Broadway St, North Bend, OR 97459 | 2012-07-27 |
| 1366728370 | Melissa Jean Kovach | Occupational Therapy Assistant | 3959 Sheridan Ave., North Bend, OR 97459 | 2011-10-24 |
| 1295045052 | Mary Kay Weikel | Massage Therapist | 3229 Broadway St Suite G Serenity Therapy Center, North Bend, OR 97459 | 2010-10-14 |
| 1902080013 | Anthony Eugene Baldacci | Registered Nurse | 1836 Meade Street, North Bend, OR 97459 | 2007-12-26 |
| 1952595340 | Inland Point Senior Estates Jv LLC | Clinic/Center | 2265 Inland Drive, North Bend, OR 97459 | 2007-08-29 |
| Find all providers in zip 97459 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528423522 | Jaclyn Carricato | Military Health Care Provider | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2015-12-18 |
| 1407054323 | Medical Department Uscg | Military Health Care Provider | 2000 Connecticut Ave, North Bend, OR 97459-2300 | 2007-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831371525 | Rebecca Barron | Military Health Care Provider | 6767 North Basin Ave, Portland, OR 97217 | 2007-12-04 |
| 1962696468 | Joseph Paul Stein | Military Health Care Provider | 39302 Stratford Pl, Sandy, OR 97055-5314 | 2007-08-29 |
| 1275025389 | Sophia Maclean | Military Health Care Provider | 11035 Ne Sandy Blvd, Portland, OR 97220-2553 | 2018-06-04 |
| 1730352766 | Emily Rae Gunesch | Military Health Care Provider | 1500 Ne Irving St, Portland, OR 97232-2243 | 2008-04-10 |
| City | NORTH BEND |
| Zip Code | 97459 |
Please comment or provide details below to improve the information on US COAST GUARD MEDICAL CLINIC NORTH BEND.
| 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.