PORTLAND MEDICAL IMAGING LLC (NPI# 1932162906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932162906 |
| Entity Type | Organization |
| Organization Name | PORTLAND MEDICAL IMAGING LLC |
| Practice Address |
10538 Se Washington St Portland OR 97216-2809 |
| Practice Telephone | 5032158900 |
| Practice Fax Number | 5032158920 |
| Mailing Telephone | 5032158900 |
| Mailing Fax Number | 5032158920 |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2007-10-01 |
| Authorized Official Name | RONALD KIZZIAR (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Telephone | 5032158900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians |
| Street Address |
10538 SE WASHINGTON ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97216-2809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316468341 | Accident Care Chiropractic and Massage of Salem | Clinic/Center | 2168 Lancaster Dr. Ne, Portland, OR 97216 | 2017-06-29 |
| 1528508520 | Damone Brown | Peer Specialist | 10209 Se Washington St, Suite D, Portland, OR 97216 | 2017-02-24 |
| 1861937237 | Malachai Investments LLC | Clinical Medical Laboratory | 10,000 Se Main St, Ste 360, Portland, OR 97216 | 2016-12-21 |
| 1881136836 | Krista Marie Darnell | Occupational Therapy Assistant | 1475, Se 100th Avenue, Portland, OR 97216 | 2016-11-08 |
| 1821456559 | Sean Kelly | Counselor | 10564 Se Washington Street, Portland, OR 97216 | 2016-02-09 |
| 1174908321 | Phil Bergland | Counselor | 11220 Se Stark St, Suite 6, Portland, OR 97216 | 2015-07-29 |
| 1134507346 | Beth Lopez | Massage Therapist | 5814 Se Stark Street, Portland, OR 97216 | 2015-05-08 |
| 1982081477 | Amelia C Hunt | Counselor | 10564 Se Washinton Street, Portland, OR 97216 | 2015-05-04 |
| 1073907978 | Karen Ta | Emergency Medicine | 10300 Se Main St, Portland, OR 97216 | 2015-03-27 |
| 1265823298 | Laura Catherine Anderson | Occupational Therapist | 1475 Se 100th Avenue, Portland, OR 97216 | 2015-02-12 |
| Find all providers in zip 97216 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124221783 | Charles A Kosydar | Radiology | 9400 Sw Barnes Rd, Suite 150, Portland, OR 97225-6608 | 2007-06-08 |
| 1316262108 | Jonathan Carnell | Radiology | 5050 Ne Hoyt St Ste 625, Portland, OR 97213-2991 | 2010-04-05 |
| 1770745846 | Justin Christopher Ord | Radiology | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2008-06-30 |
| 1033272059 | Thomas Frederick Hirsh | Radiology | 800 Sw 13th Ave, Portland, OR 97205 | 2006-12-19 |
| 1669540506 | Shaun D Samuelson | Radiology | 22 Bramhall St, Portland, ME 04102-3134 | 2006-11-30 |
| 1487681375 | Elena Wechsler | Radiology | 144 State St, Portland, ME 04101-3776 | 2006-06-27 |
| 1306800453 | Fergus Coakley | Radiology | 3181 Sw Sam Jackson Park Rd, Ohsu, Portland, OR 97239-3011 | 2006-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174774285 | Ronald P Morro | Radiology | 315 Winchuck River Rd, Brookings, OR 97415-8311 | 2008-10-07 |
| 1326513367 | Confederated Tribes of Grand Ronde Community of Oregon | Radiology | 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | 2018-10-05 |
| 1629140793 | Harvard Lab & X-ray, Inc | Radiology | 1813 W Harvard Ave, Suite 102, Roseburg, OR 97470-2752 | 2006-11-14 |
| 1720170590 | Tyler B Lippincott | Radiology | 233 Ne 102nd Ave, Portand, OR 97220 | 2006-09-29 |
| 1285730267 | Susan Irene Wolf | Radiology | 10180 Se Sunnyside Rd, Kaiser Sunnyside Medical Office, Clackamas, OR 97015-8970 | 2006-09-16 |
| 1518063973 | Josephine O Cho | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2006-09-15 |
| 1386746782 | Ronald Wayne Philips | Radiology | 10180 Se Sunnyside Rd, Clackamas, OR 97015-9764 | 2006-09-05 |
| 1619946563 | Joe A Pastrano | Radiology | 842 E Main St, Medford, OR 97504-7134 | 2006-03-14 |
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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.