PORTLAND PREVENTIVE CARDIOLOGY LLC (NPI# 1912241746) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912241746 |
| Entity Type | Organization |
| Organization Name | PORTLAND PREVENTIVE CARDIOLOGY LLC |
| Practice Address |
8855 Sw Canyon Ln Portland OR 97225-3411 |
| Practice Telephone | 5032925678 |
| Practice Fax Number | 5032926665 |
| Mailing Telephone | 5032925678 |
| Mailing Fax Number | 5032926665 |
| Enumeration Date | 2012-11-16 |
| Last Update Date | 2012-11-16 |
| Authorized Official Name | DR. MAUREEN ELLEN MAYS (SOLE MEMBER) |
| Authorized Official Telephone | 5032925678 |
| Authorized Official Credential | MD, MS, FACC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
MD25708 | OR | Ambulatory Health Care Facilities |
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
MD25708 | OR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 213623 | 05 | |
| DEA | BM6442658 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PORTLAND PREVENTIVE CARDIOLOGY LLC | 7535 Nw Skyline Blvd, Portland, OR 97229 |
| Street Address |
8855 SW CANYON LN |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-3411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| 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 | ||||
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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.