Dmitriy Shore (NPI# 1124177902, PAC ID# 9830143460) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1124177902 |
| PAC ID by PECOS | 9830143460 |
| Professional Enrollment ID | I20140522002443 |
| Full Name | Dmitriy Shore |
| Organization Legal Name | ADVANCED PAIN MANAGEMENT CENTER |
| Address |
10305 Sw Park Way Suite 300 Portland OR 97225-5033 |
| Phone Number | 5032950730 |
| Gender | M |
| Credential | PA |
| Graduation Year | 2000 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0648169029 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380004 | PROVIDENCE ST VINCENT MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 10305 Sw Park Way, Suite 300, Portland, OR 97225-5033 | 5032950730 | ADVANCED PAIN MANAGEMENT CENTER |
| Organization Legal Name | ADVANCED PAIN MANAGEMENT CENTER |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vladimir B Fiks | Interventional Pain Management | Advanced Pain Management Center | 10305 Sw Park Way, Suite 300, Portland, OR 97225-5033 |
| Bridget Lahm | Physician Assistant | Advanced Pain Management Center | 10305 Sw Park Way, Suite 300, Portland, OR 97225-5033 |
| Street Address |
10305 SW PARK WAY SUITE 300 |
| City | PORTLAND |
| State | OR |
| Zip | 97225-5033 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vladimir B Fiks | Interventional Pain Management | Advanced Pain Management Center | 10305 Sw Park Way, Suite 300, Portland, OR 97225-5033 |
| Bridget Lahm | Physician Assistant | Advanced Pain Management Center | 10305 Sw Park Way, Suite 300, Portland, OR 97225-5033 |
| Lee R Oconnor | Physical Therapy | 10305 Sw Park Way, Suite 201, Portland, OR 97225-5033 | |
| Timothy Grant Madison Ii | Physical Therapy | Synergy Spine Therapy, Inc. | 10305 Sw Park Way, Suite 201, Portland, OR 97225-5033 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robyn L Finseth | Chiropractic | 4850 Sw Scholls Ferry Rd, Suite 205, Portland, OR 97225-1692 | |
| Ayla Jade Himmelsbach | Optometry | Nimbus Vision Clinic, LLC | 8566 Sw Apple Way, Portland, OR 97225-1772 |
| Mary A Domm | Chiropractic | 8550 Sw Apple Way, Portland, OR 97225-1772 | |
| David J Mcbride | Optometry | Nimbus Vision Clinic, LLC | 8566 Sw Apple Way, Portland, OR 97225-1772 |
| Jeffrey E Devine | Chiropractic | Devine Chiropractic Inc | 8225 Sw Apple Way, Suite 100, Portland, OR 97225-1783 |
| Christine Rose Adriano Walty | Chiropractic | Devine Chiropractic Inc | 8225 Sw Apple Way, Suite 100, Portland, OR 97225-1783 |
| Ronald E Pacheco | Chiropractic | Devine Chiropractic Inc | 8225 Sw Apple Way, Suite 100, Portland, OR 97225-1783 |
| Barry D Shulak | Chiropractic | Devine Chiropractic Inc | 8225 Sw Apple Way, Suite 100, Portland, OR 97225-1783 |
| Robert D Peek | Optometry | 5045 Sw 77th Ave, Portland, OR 97225-1812 | |
| William F Mcbride | Family Medicine | 4475 Sw Scholls Ferry Rd, Suite 150, Portland, OR 97225-1957 | |
| Find all physicians in zip 97225 | |||
| City | PORTLAND |
| Zip Code | 97225 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | PORTLAND + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Dmitriy Shore.
| 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.