Bethany Tara Samuelson Bannow (NPI# 1619267556, PAC ID# 0345566857) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is HEMATOLOGY/ONCOLOGY.
| Nation Provider ID (NPI) | 1619267556 |
| PAC ID by PECOS | 0345566857 |
| Professional Enrollment ID | I20180208003086 |
| Full Name | Bethany Tara Samuelson Bannow |
| Organization Legal Name | OREGON HEALTH AND SCIENCE UNIVERSITY |
| Address |
707 Sw Gaines St Portland OR 97239-2901 |
| Phone Number | 5034922709 |
| Gender | F |
| Medical School | OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2011 |
| Primary Specialty | HEMATOLOGY/ONCOLOGY |
| Group Practice PAC ID | 4284542945 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380009 | OHSU HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 5034185505 | UNIVERSITY PROFESSIONAL SERVICES |
| 707 Sw Gaines St, Portland, OR 97239-2901 | 5034922709 | OREGON HEALTH AND SCIENCE UNIVERSITY |
| Organization Legal Name | OREGON HEALTH AND SCIENCE UNIVERSITY |
| Physicians | 85 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Peter W Morita | Oral Surgery | Oregon Health and Science University | 611 Swcampus Dr, Portland, OR 97239-3001 |
| Jeffery Wise | Nurse Practitioner | Oregon Health and Science University | 3930 Se Division St, Portland, OR 97202-1643 |
| Toy Lim | Nurse Practitioner | Oregon Health and Science University | 4212 Se Division St, Suite 150, Portland, OR 97206-1681 |
| Brigit A Hatch | Family Medicine | Oregon Health and Science University | 546 Ne 12th Ave, Rm 126, Portland, OR 97232-2719 |
| Joe M Skariah | Family Medicine | Oregon Health and Science University | 51377 Sw Old Portland Rd, Scappoose, OR 97056-4023 |
| Ashley Atwood | Physician Assistant | Oregon Health and Science University | 51377 Sw Old Portland Rd, Scappoose, OR 97056-4023 |
| Jeanene A Smith | Family Medicine | Oregon Health and Science University | 3930 Se Division St, Portland, OR 97202-1643 |
| Richard W. Moberly | Family Medicine | Oregon Health and Science University | 51377 Sw Old Portland Rd, Scappoose, OR 97056-4023 |
| Christopher I Michel | Physician Assistant | Oregon Health and Science University | 51377 Sw Old Portland Rd, Scappoose, OR 97056-4023 |
| Jennifer Schlobohm | Clinical Social Worker | Oregon Health and Science University | 3930 Se Division St, Portland, OR 97202-1643 |
| Street Address |
707 SW GAINES ST |
| City | PORTLAND |
| State | OR |
| Zip | 97239-2901 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Maureen Delongis | Clinical Social Worker | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Randall A Phelps | Pediatric Medicine | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Joseph D Pinter | Neurology | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Arlene Hagen | Psychiatry | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Daniel Joseph Crowder | Pediatric Medicine | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Andrew Munson Henning | Nurse Practitioner | Oregon Health and Science University | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Cary O Harding | Pediatric Medicine | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Susanne W. Duvall | Clinical Psychologist | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Mario C Petersen | Pediatric Medicine | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Karin M Ide | Nurse Practitioner | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael Justin Arnot | Chiropractic | 6339 Sw Capitol Hwy, Portland, OR 97239-1937 | |
| Rachel Murphy | Optometry | Abc Optometric PC | 1522 Sw Sunset Blvd, Portland, OR 97239-2626 |
| Steven G Tillett | Podiatry | 6274 Sw Capitol Hwy, Portland, OR 97239-2674 | |
| Susannah B Castle | Psychologist, Clinical | 1509 Sw Sunset Blvd, Suite 2c, Portland, OR 97239-2689 | |
| Joshua Louis Clark | Psychologist, Clinical | 1509 Sw Sunset Blvd, Suite 2c, Portland, OR 97239-2689 | |
| Diana Martha Clark | Clinical Social Worker | 4714 Sw 2nd Ave, Portland, OR 97239-2890 | |
| Becky J Whittemore | Nurse Practitioner | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Rita Panoscha | Pediatric Medicine | University Professional Services | 707 Sw Gaines St, Portland, OR 97239-2901 |
| Peter W Morita | Oral Surgery | Oregon Health and Science University | 611 Swcampus Dr, Portland, OR 97239-3001 |
| Ying Wu | Oral Surgery | 611 Sw Campus Dr Rm, 119 Ohsu Faculty Dental Practice, Portland, OR 97239-3001 | |
| Find all physicians in zip 97239 | |||
| City | PORTLAND |
| Zip Code | 97239 |
| Specialty | HEMATOLOGY/ONCOLOGY |
| City + Specialty | PORTLAND + HEMATOLOGY/ONCOLOGY |
Please comment or provide details below to improve the information on Bethany Tara Samuelson Bannow.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.