| Integrated Joint Specialists LLC | |
|
10250 Sw Greenburg Rd 4 Lincoln Center, Suite 125 Tigard OR 97223-5470 | |
| (503) 719-6783 | |
| (971) 327-6734 |
| Full Name | Integrated Joint Specialists LLC |
|---|---|
| Speciality | General Practice |
| Location | 10250 Sw Greenburg Rd, Tigard, Oregon |
| Authorized Official Name and Position | Russell Riggs (MANAGING MEMBER) |
| Authorized Official Contact | 5035828283 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Joint Specialists LLC 10250 Sw Greenburg Rd Ste 115 Tigard OR 97223-5461 Ph: (503) 719-6783 | Integrated Joint Specialists LLC 10250 Sw Greenburg Rd 4 Lincoln Center, Suite 125 Tigard OR 97223-5470 Ph: (503) 719-6783 |
| NPI Number | 1942502794 |
|---|---|
| Provider Enumeration Date | 11/30/2010 |
| Last Update Date | 09/01/2021 |
| Certification Date | 09/01/2021 |
| Medicare PECOS PAC ID | 7517148554 |
|---|---|
| Medicare Enrollment ID | O20110223000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942502794 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
| 225100000X | Physical Therapist | () | Secondary |
| Provider Name | Russell W Riggs |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356384838 PECOS PAC ID: 1658312343 Enrollment ID: I20050512000453 |
| Provider Name | Natacha Y Yonezuka-gullo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689655938 PECOS PAC ID: 2163455056 Enrollment ID: I20050926000608 |
| Provider Name | Tania Mila Shaw |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184665416 PECOS PAC ID: 6305825282 Enrollment ID: I20071003000603 |
| Provider Name | Brad G Simpson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518900174 PECOS PAC ID: 6103847603 Enrollment ID: I20081013000127 |
| Provider Name | Ryan G Maxwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316352651 PECOS PAC ID: 6901193812 Enrollment ID: I20160921000083 |
| Provider Name | Amber Vogt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548400682 PECOS PAC ID: 4183750979 Enrollment ID: I20180205002775 |
| Provider Name | Darren T Nigo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194276022 PECOS PAC ID: 3870838766 Enrollment ID: I20181220003373 |
| Provider Name | Marc K Obando |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710354337 PECOS PAC ID: 9032596556 Enrollment ID: I20220521000039 |
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Fred Meyer Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11565 Sw Pacific Hwy, Tigard, OR 97223 Phone: 503-293-7085 |
Providence Medical Group Scholls Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12442 Sw Scholls Ferry Rd, Suite 100, Tigard, OR 97223 Phone: 503-216-9200 Fax: 503-216-9220 |
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