DR. KRISTINE ROESEN (NPI# 1962644005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962644005 |
| Entity Type | Individual |
| Full Name | DR. KRISTINE ROESEN |
| Credential | M.D. |
| Practice Address |
2801 N Gantenbein Ave Legacy Health Portland OR 97227-1623 |
| Mailing Address |
Po Box 3777 Legacy Health Portland OR 97208-3777 |
| Practice Telephone | 5034134278 |
| Practice Fax Number | 5034135222 |
| Mailing Telephone | 5034133900 |
| Mailing Fax Number | 5034133710 |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2013-09-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | MD164090 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
2801 N GANTENBEIN AVE LEGACY HEALTH |
| City | PORTLAND |
| State | OR |
| Zip Code | 97227-1623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124027198 | James P Mccord | Pediatrics | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2005-07-20 |
| 1225639040 | Lina Rossetti-grulich | Nurse Practitioner | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-11-06 |
| 1033722673 | Karen Bronson | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-08-24 |
| 1356969331 | Sandy Hammer | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2020-07-07 |
| 1225673999 | Odaisa Igwe | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-11-16 |
| 1952945578 | Julie Lorine Hoover | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-11-06 |
| 1285278648 | Kate Harrell Unterberger | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-29 |
| 1780227082 | Keegan Carly Fritzke | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-21 |
| 1578106860 | Corinne Frohlick | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-20 |
| 1386287662 | Aimee Breitfelder Reddy | Pharmacist | 2801 N Gantenbein Ave, Portland, OR 97227-1623 | 2019-10-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1851955975 | Erin Marie Staples | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave;, Suite 230, Portland, OR 97227 | 2019-04-24 |
| 1922588508 | Melanie Grace Mix | Physician Assistant | 501 N Graham St Ste 420, Portland, OR 97227 | 2018-08-14 |
| 1730615071 | Mehran Giblin | Student in an Organized Health Care Education/Training Program | 2800 N. Vancouver Ave, Suite 230, Legacy Clinic Emanuel, Portland, OR 97227 | 2017-05-05 |
| 1730623687 | Christina Grace Belter | Optometrist | 300 N Graham St Ste 300, Portland, OR 97227 | 2016-12-12 |
| 1407300205 | Jenna Abernathy | Counselor | 3537 N Williams Ave, Portland, OR 97227 | 2016-08-09 |
| 1215390760 | Tanya Marie Woods | Massage Therapist | 3808 N. Williams Ave., Portland, OR 97227 | 2016-04-01 |
| 1033596853 | Eric Allen Martin | Counselor | 2054 N. Vancouver Ave, Portland, OR 97227 | 2015-04-30 |
| 1285040436 | Berk Neurosurgical LLC | Neurological Surgery | 501 N Graham St Ste 500, Portland, OR 97227 | 2014-07-09 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215396676 | Hanalore Griffiths | Obstetrics & Gynecology | 11750 Sw Barnes Rd Ste 300, Portland, OR 97225-5911 | 2016-02-14 |
| 1487057790 | William Russell Greene | Obstetrics & Gynecology | 2239 Ne 19th Ave, Portland, OR 97212-4616 | 2014-09-30 |
| 1538587654 | Gene De Haan | Obstetrics & Gynecology | 3350 N Interstate Ave, Obstretrics and Gynecology, Portland, OR 97227-3011 | 2014-04-04 |
| 1043650682 | Tuesday Elizabeth Pearson | Obstetrics & Gynecology | 2332 Nw Irving St., Portland, OR 97210 | 2013-06-27 |
| 1760820385 | John Ogorek | Obstetrics & Gynecology | 100 Brickhill Ave Ste 23, Portland, ME 04106-1999 | 2013-06-05 |
| 1841557170 | Eleonore Pettit Werner | Obstetrics & Gynecology | 84 Marginal Way Ste 900, Portland, ME 04101-2476 | 2012-04-11 |
| 1508152026 | Kelli Andersen | Obstetrics & Gynecology | 10000 Se Main St Ste 10, Portland, OR 97216-2441 | 2011-06-22 |
| 1831494087 | Katie Alton | Obstetrics & Gynecology | 3181 Sw Sam Jackson Park Rd # Uhn50, Portland, OR 97239-3011 | 2011-01-20 |
| 1386955037 | Chidimma Uche Abanulo | Obstetrics & Gynecology | 9701 Sw Banes Rd, Suite 150, Portland, OR 97225 | 2010-06-28 |
| 1982920393 | Leo Liu Han | Obstetrics & Gynecology | 3181 Sw Sam Jackson Park Road, Mailcode: L466, Oregon Health and Science University, Portland, OR 80045 | 2010-04-09 |
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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.