EASTSIDE ALLERGY ASTHMA & GENERAL INTERNAL MEDICINE PC (NPI# 1922304302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922304302 |
| Entity Type | Organization |
| Organization Name | EASTSIDE ALLERGY ASTHMA & GENERAL INTERNAL MEDICINE PC |
| Practice Address |
2850 Se Powell Blvd Suite 206 Gresham OR 97080-1494 |
| Practice Telephone | 5036665025 |
| Practice Fax Number | 5036665795 |
| Mailing Telephone | 5036665025 |
| Mailing Fax Number | 5036665795 |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2011-02-02 |
| Authorized Official Name | DR. AUSTIN UNDERWOOD SARGENT (PRESIDENT/OWNER) |
| Authorized Official Telephone | 5036665025 |
| Authorized Official Credential | M.D. PHD |
| Is Organization Subpart | Y |
| Parent Organization Name | EASTSIDE ALLERGY, ASTHMA & GENERAL INTERNAL MEDICINE PC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
MD21072 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 151110 | 05 |
| Street Address |
2850 SE POWELL BLVD SUITE 206 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97080-1494 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528428554 | Jeffrey Henry Lucero | Social Worker | 4687 Se 1st Terrace, Gresham, OR 97080 | 2016-03-03 |
| 1124371059 | Nickole Turner | Massage Therapist | 2831 Se Palmquist Rd #157, Gresham, OR 97080 | 2012-10-16 |
| 1992061048 | Russell A Wendt | Pharmacist | 2497 Ne Roberts Ave, Gresham, OR 97080 | 2012-04-03 |
| 1821385584 | Angela West | Counselor | 320 Sw 6th Ave., Gresham, OR 97080 | 2011-07-01 |
| 1043543572 | Natalie Dawn Wilson | Behavioral Analyst | 97 Sw Riverview Place, Gresham, OR 97080 | 2009-09-16 |
| 1427205442 | Maria G Jolley | Dental Hygienist | 1267 Se Stapleton Loop, Gresham, OR 97080 | 2008-08-21 |
| 1073776738 | Sabrina Joye Hindman | Marriage & Family Therapist | 6370 Se 26th St, Gresham, OR 97080 | 2008-07-03 |
| 1669676193 | Kimberly Sabin | Nurse Practitioner | 2222 E Powell Blvd, Gresham, OR 97080 | 2007-06-11 |
| 1932223880 | Julie Elizabeth Croshaw | Pharmacist | 2444 E Powell Blvd, Gresham, OR 97080 | 2007-03-18 |
| 1508903261 | Lonetta Elise Davis | Adult Companion | 349 Se Plamblad, Gresham, OR 97080 | 2007-01-31 |
| Find all providers in zip 97080 | ||||
| Taxonomy Code | 207KA0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Allergy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164562401 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 2628 Clover St, Klamath Falls, OR 97601-1132 | 2007-02-07 |
| 1205976867 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 2262 Ashland St, Ashland, OR 97520-1406 | 2007-02-06 |
| 1952441594 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 1722 Williams Hwy, Grants Pass, OR 97527-5661 | 2007-02-06 |
| 1760548408 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 3860 Crater Lake Ave Ste A, Medford, OR 97504-9741 | 2006-12-28 |
| 1194733519 | Joel Michael Depper | Allergy & Immunology | 1250 Ne 3rd St, Suite B-100, Bend, OR 97701-4331 | 2006-08-03 |
| 1568482610 | Robert Henry Schwartz | Allergy & Immunology | 27 Ne Killingsworth St, Portland, OR 97211-2623 | 2006-07-20 |
| 1659317683 | John D Minor | Allergy & Immunology | 2233-f Willamette St, Allergy & Asthma Center PC, Eugene, OR 97405 | 2006-06-20 |
| 1134100092 | Kevin M Kral | Allergy & Immunology | 2065 Ne Williamson Ct, Suite A, Bend, OR 97701-3867 | 2005-11-08 |
| 1568465847 | Edward Kerwin | Allergy & Immunology | 3860 Crater Lake Ave, Medford, OR 97504-9741 | 2005-05-31 |
| 1851954853 | Allergy & Asthma Center of Southern Oregon PC | Allergy & Immunology | 1813 W Harvard Ave, Suite 241, Roseburg, OR 97471 | 2019-04-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EASTSIDE ALLERGY ASTHMA & GENERAL INTERNAL MEDICINE PC.
| 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.