MICHAEL H WALCZYK (NPI# 1871562892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871562892 |
| Entity Type | Individual |
| Full Name | MICHAEL H WALCZYK |
| Credential | MD |
| Practice Address |
1130 Nw 22nd Ave Ste 400 Portland OR 97210-2971 |
| Mailing Address |
Po Box 4037 Portland OR 97208-4037 |
| Practice Telephone | 5034136722 |
| Practice Fax Number | 5034136563 |
| Mailing Telephone | 5034134048 |
| Mailing Fax Number | 5034132910 |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-01-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
MD19676 | HI | Allopathic & Osteopathic Physicians |
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
23874 | WA | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
13217 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1029586 | 05 | |
| OR | 147116 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1130 Nw 22nd Ave Ste 640, Portland, OR 972102993 | 5032297976 | 5032744867 |
| 75 Puuhonu Pl Ste 100, Hilo, HI 967202000 | 8089358647 | 8089359783 |
| Street Address |
1130 NW 22ND AVE STE 400 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210-2971 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235313214 | Jeff Chamberlain | Pharmacist | 1130 Nw 22nd Ave Ste 400, Portland, OR 97210-2971 | 2007-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| 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 |
|---|---|---|---|---|
| 1184133746 | Abd Assalam Qannus | Internal Medicine | 22 Bramhall St Rm 5219, Portland, ME 04102-3134 | 2017-09-27 |
| 1023403748 | Sarah Gilligan | Internal Medicine | 19 Capisic St, Portland, ME 04102-2203 | 2015-03-31 |
| 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 |
| Find all providers in PORTLAND | ||||
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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.