Dustin Shackleton (NPI# 1942445119, PAC ID# 5496940124) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PATHOLOGY.
| Nation Provider ID (NPI) | 1942445119 |
| PAC ID by PECOS | 5496940124 |
| Professional Enrollment ID | I20101108001153 |
| Full Name | Dustin Shackleton |
| Organization Legal Name | AFFILIATED PATHOLOGISTS MEDICAL GROUP, INC. |
| Address |
1000 3rd St Tillamook OR 97141-3430 |
| Phone Number | 5032516129 |
| Gender | M |
| Medical School | UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE |
| Graduation Year | 2005 |
| Primary Specialty | PATHOLOGY |
| Group Practice PAC ID | 7315840535 |
| Number of Group Practice Members | 34 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380060 | ADVENTIST MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 10123 Se Market St, Portland, OR 97216-2532 | 5038152465 | AFFILIATED PATHOLOGISTS MEDICAL GROUP, INC. |
| 2374 E Pacifica Pl, Rancho Dominguez, CA 90220-6214 | 3102253244 | AFFILIATED PATHOLOGISTS MEDICAL GROUP, INC. |
| 1000 3rd St, Tillamook, OR 97141-3430 | 5032516129 | AFFILIATED PATHOLOGISTS MEDICAL GROUP, INC. |
| Organization Legal Name | AFFILIATED PATHOLOGISTS MEDICAL GROUP, INC. |
| Physicians | 38 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nicolas Gallegos | Pathology | Affiliated Pathologists Medical Group, Inc. | 2374 E Pacifica Pl, Rancho Dominguez, CA 90220-6214 |
| Alfred M Yamamoto | Pathology | Affiliated Pathologists Medical Group, Inc. | 3700 E S St, Lakewood, CA 90805-4521 |
| Vivian Mendoza | Pathology | Affiliated Pathologists Medical Group, Inc. | 1680 E 120th St, Mlk Hospital, Los Angeles, CA 90059-3026 |
| Lindsay Zamis Dellamaggiora | Pathology | Affiliated Pathologists Medical Group, Inc. | 1225 Wilshire Blvd, Los Angeles, CA 90017-1901 |
| Jennifer F O Dell | Pathology | Affiliated Pathologists Medical Group, Inc. | 4101 Torrance Blvd, Torrance, CA 90503-4607 |
| Ronald W Slaughter | Pathology | Affiliated Pathologists Medical Group, Inc. | 10 Woodland Rd, Pathology Department, St Helena, CA 94574-9554 |
| Galen R Cortina | Pathology | Affiliated Pathologists Medical Group, Inc. | 1225 Wilshire Blvd, Los Angeles, CA 90017-1901 |
| Hany M Halawa | Pathology | Affiliated Pathologists Medical Group, Inc. | 2374 E Pacifica Pl, Rancho Dominguez, CA 90220-6214 |
| Georgia Liles Tunstill | Pathology | Affiliated Pathologists Medical Group, Inc. | 350 Terracina Blvd, Redlands, CA 92373-4850 |
| Kelli Aleece Chase | Pathology | Affiliated Pathologists Medical Group, Inc. | 15630 18th Ave, Clearlake, CA 95422-9336 |
| Street Address |
1000 3RD ST |
| City | TILLAMOOK |
| State | OR |
| Zip | 97141-3430 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Curtis R Nerness | Internal Medicine | Rural Physicians Group Pannu Pllc | 1000 3rd St, Tillamook, OR 97141-3430 |
| Ryan M Kealy | Hospitalist | Rural Physicians Group Pannu Pllc | 1000 3rd St, Tillamook, OR 97141-3430 |
| Andrew F Nelson | Diagnostic Radiology | Northwest Medical Foundation of Tillamook | 1000 3rd St, Tillamook, OR 97141-3430 |
| Mark V Hart | Cardiovascular Disease (cardiology) | Northwest Medical Foundation of Tillamook | 1000 3rd St, Tillamook, OR 97141-3430 |
| Gregory J Opdahl | Anesthesiology | Northwest Medical Foundation of Tillamook | 1000 3rd St, Tillamook, OR 97141-3430 |
| Emmanuel Obinna Ogbodo | Internal Medicine | Rural Physicians Group Pannu Pllc | 1000 3rd St, Tillamook, OR 97141-3430 |
| Frederick A Foss | General Surgery | Northwest Medical Foundation of Tillamook | 1000 3rd St, Tillamook, OR 97141-3430 |
| Andrew Michael Pace | Family Medicine | Rural Physicians Group Pannu Pllc | 1000 3rd St, Tillamook, OR 97141-3430 |
| Jennifer N Perry | Certified Registered Nurse Anesthetist (crna) | Northwest Medical Foundation of Tillamook | 1000 3rd St, Tillamook, OR 97141-3430 |
| Myra L Thompson | Nurse Practitioner | Northwest Medical Foundation of Tillamook | 1000 3rd St, Tillamook, OR 97141-3430 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel R Arthur | Nurse Practitioner | 216 Cedar Ave, Tillamook, OR 97141-2000 | |
| Raymond K Dehaan | Optometry | 310 Stillwell Ave, Tillamook, OR 97141-2119 | |
| John G Dodd | Ophthalmology | Coastal Eyecare Tillamook LLC | 102 Main Ave, Tillamook, OR 97141-2218 |
| David Anthony Biggar | Optometry | Eyes of Oregon, LLC | 102 Main Ave, Tillamook, OR 97141-2218 |
| Rodney G Jackson | Chiropractic | 309 Laurel Ave, Tillamook, OR 97141-2313 | |
| Matthew S Waxter | Chiropractic | 312 Laurel Ave, Suite 1, Tillamook, OR 97141-2314 | |
| Patricia A Blondo | Clinical Social Worker | 2308 1st St, Suite 5, Tillamook, OR 97141-2407 | |
| Jeremy S Johnston | Physician Assistant | Northwest Medical Foundation of Tillamook | 1100 3rd St, Tillamook, OR 97141-3402 |
| Christopher K Kruebbe | Clinical Social Worker | Northwest Medical Foundation of Tillamook | 1100 3rd St, Tillamook, OR 97141-3402 |
| David A Bradburn | Family Medicine | Northwest Medical Foundation of Tillamook | 1100 3rd St, Tillamook, OR 97141-3402 |
| Find all physicians in zip 97141 | |||
| City | TILLAMOOK |
| Zip Code | 97141 |
| Specialty | PATHOLOGY |
| City + Specialty | TILLAMOOK + PATHOLOGY |
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| 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.