| David Nerseth Irvine, MD | |
|
1809 Maple St, Forest Grove, OR 97116-1939 | |
| (503) 357-2173 | |
| (503) 357-2318 |
| Full Name | David Nerseth Irvine |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 1809 Maple St, Forest Grove, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366483109 | NPI | - | NPPES |
| 6751HU | Other | WA | BSWA |
| 8240871 | Medicaid | WA | |
| 8946238 | Other | WA | VCR |
| 059253 | Medicaid | OR | |
| 0216865 | Other | WA | LIWA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | MD15519 (Oregon) | Primary |
| Entity Name | Southern Humboldt Community Healthcare District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003819376 PECOS PAC ID: 8820982879 Enrollment ID: O20100106000632 |
| Mailing Address | Practice Location Address |
|---|---|
| David Nerseth Irvine, MD 505 S 336th St, Suite 600, Federal Way, WA 98003-6328 Ph: (253) 838-6180 | David Nerseth Irvine, MD 1809 Maple St, Forest Grove, OR 97116-1939 Ph: (503) 357-2173 |
Dr. Stephen Patrick Moon, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3838 Pacific Ave, Forest Grove, OR 97116 Phone: 503-992-0288 Fax: 503-359-4742 | |
Dr. Kimthuy Tuan Le, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1809 Maple St, Forest Grove, OR 97116 Phone: 503-357-2172 | |
John Joseph Kaib, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1809 Maple St, Forest Grove, OR 97116 Phone: 503-357-2173 Fax: 503-357-2318 | |
Miroslav Kavur, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1809 Maple St, Forest Grove, OR 97116 Phone: 503-359-6180 Fax: 503-357-2318 | |
Robert James Eichner, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1809 Maple St, Forest Grove, OR 97116 Phone: 503-359-6180 Fax: 503-357-2318 |