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 |
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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 |
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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 |
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Provider Enumeration Date | 11/30/2010 |
Last Update Date | 09/01/2021 |
Medicare PECOS PAC ID | 7517148554 |
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Medicare Enrollment ID | O20110223000613 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942502794 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
Provider Name | Russell W Riggs |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1356384838 PECOS PAC ID: 1658312343 Enrollment ID: I20050512000453 |
Provider Name | Tania Mila Shaw |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1184665416 PECOS PAC ID: 6305825282 Enrollment ID: I20071003000603 |
Provider Name | Brad G Simpson |
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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 |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316352651 PECOS PAC ID: 6901193812 Enrollment ID: I20160921000083 |
Provider Name | Amber J Vogt |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1548400682 PECOS PAC ID: 4183750979 Enrollment ID: I20180205002775 |
Provider Name | Darren T Nigo |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1194276022 PECOS PAC ID: 3870838766 Enrollment ID: I20181220003373 |
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