EVGENY I FEDOTOV (NPI# 1962412510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962412510 |
| Entity Type | Organization |
| Organization Name | EVGENY I FEDOTOV |
| Other Organization Name | NORTH WEST CLINICAL LABORATORY |
| Practice Address |
6629 Ne 82nd Ave Suite 203 Portland OR 97220-1346 |
| Practice Telephone | 5037568159 |
| Mailing Telephone | 5037568159 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | EVGENY I FEDOTOV (PRESIDENT) |
| Authorized Official Telephone | 5032525042 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | OR | Laboratories |
| Other Name | Type Code |
|---|---|
| north west clinical laboratory | Doing Business As Name - Organization |
| Street Address |
6629 NE 82ND AVE SUITE 203 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-1346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649881483 | True Diagnostics | Clinical Medical Laboratory | 1122 Ne 122nd Ave Ste B-102, Portland, OR 97230-2081 | 2020-08-14 |
| 1497363543 | Laboratory Corporation of America | Clinical Medical Laboratory | 4212 Ne Broadway Rm L100, Portland, OR 97213-1422 | 2020-07-15 |
| 1568927903 | Alerra, LLC | Clinical Medical Laboratory | 618 Nw 12th Ave Apt 412, Portland, OR 97209-3031 | 2019-02-08 |
| 1861937237 | Malachai Investments LLC | Clinical Medical Laboratory | 10,000 Se Main St, Ste 360, Portland, OR 97216 | 2016-12-21 |
| 1346559168 | Metwest Inc | Clinical Medical Laboratory | 10535 Ne Glisan St Ste 100, Portland, OR 97220-4076 | 2010-09-28 |
| 1649428285 | Holter Labs | Clinical Medical Laboratory | 7327 Sw Barnes Rd, Portland, OR 97225-6119 | 2008-09-08 |
| 1861617680 | Kashi Clinical Laboratories Inc | Clinical Medical Laboratory | 10101 Sw Barbur Blvd. Suite 200, Portland, OR 97219-5915 | 2007-04-16 |
| 1740306935 | Nunm Laboratory | Clinical Medical Laboratory | 3025 Sw Corbett Street, Portland, OR 97201 | 2007-03-21 |
| 1154454718 | Portland Tissue Processing Laboratory, Inc. | Clinical Medical Laboratory | 5012 Ne 42nd Ave, Portland, OR 97218-1504 | 2007-03-13 |
| 1144399304 | Reproductive Medicine Laboratory | Clinical Medical Laboratory | 2222 Nw Lovejoy St Ste 304, Portland, OR 97210-5100 | 2006-11-06 |
| 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.