NORTHWEST PEDIATRIC KIDNEY SPECIALISTS LLC (NPI# 1801098108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801098108 |
| Entity Type | Organization |
| Organization Name | NORTHWEST PEDIATRIC KIDNEY SPECIALISTS LLC |
| Practice Address |
1935 Nw Norfolk Ct Portland OR 97229-8448 |
| Practice Telephone | 5032973178 |
| Mailing Telephone | 5032973178 |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2012-05-18 |
| Authorized Official Name | DR. RANDALL JENKINS (DOCTOR) |
| Authorized Official Telephone | 5032973178 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0210X |
Pediatrics Specialization: Pediatric Nephrology |
MD12771 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 080767 | 05 | |
| WA | 7077415 | 05 |
| Street Address |
1935 NW NORFOLK CT |
| City | PORTLAND |
| State | OR |
| Zip Code | 97229-8448 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919906 | Anjana Rajan | Counselor | Lifeworks Northwest, 14600 Nw Cornell Rd, Portland, OR 97229 | 2020-07-06 |
| 1871138453 | Kedrick Starr | Case Manager/Care Coordinator | 14600 Nw Cornell Rd., Portland, OR 97229 | 2019-11-07 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1669026134 | Alexandra Elizabeth Lodwig | Speech-Language Pathologist | 255 Nw Lost Springs Terrace Apt 304, Portland, OR 97229 | 2019-08-01 |
| 1003316043 | Jenny Lavonne Thom | Counselor | 15220 Nw Laidlaw Rd., Suite 280, Portland, OR 97229 | 2018-02-16 |
| 1194230664 | Ankita Guchait | Case Manager/Care Coordinator | 14600 Nw Cornell Rd, Portland, OR 97229 | 2017-12-06 |
| 1568988913 | Hannah Hendrix Klingelheber | Speech-Language Pathologist | 15605 Nw Ryegrass St., Portland, OR 97229 | 2017-08-17 |
| 1548791213 | Adeline Mitchell | Registered Nurse | 14600 Sw Cornell Rd., Portland, OR 97229 | 2017-03-24 |
| 1538610670 | Crystal Graves | Peer Specialist | 14600 Nw Cornell, Portland, OR 97229 | 2016-10-24 |
| 1639533185 | Evelin James | Dental Hygienist | 5879 Nw Lark Meadow Ter, Portland, OR 97229 | 2016-04-11 |
| Find all providers in zip 97229 | ||||
| Taxonomy Code | 2080P0210X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Nephrology |
| A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy. |
| 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/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194042481 | Ronald Zviti | Pediatrics | 887 Congress St Ste 300, Portland, ME 04102-3103 | 2010-04-26 |
| 1164646485 | Sharon W Su | Pediatrics | 501 N Graham St, Suite 315, Portland, OR 97227 | 2007-04-11 |
| 1699877258 | Jeanne Mowry | Pediatrics | 3550 N Interstate Ave, Portland, OR 97227-1196 | 2006-09-03 |
| 1881600336 | David Joel Rozansky | Pediatrics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-08-01 |
| 1780699280 | Amira Al-uzri | Pediatrics | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2006-07-31 |
| 1710955018 | Edward Nigel Guillery | Pediatrics | 501 N Graham St, Suite 340, Portland, OR 97227-1654 | 2006-03-10 |
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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.