Stateserv Medical of Oregon, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

STATESERV MEDICAL OF OREGON, LLC

Practice address

26100 SW 95TH Ave
Suite 200
Wilsonville, OR 97070

Phone

(503) 729-2371

Fax

(503) 598-9737

NPI assigned

Sep 30, 2011

Organization subpart

Yes

Parent organization

THE STATESERV COMPANIES LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christopher Roode

Title

Coo

Phone

(877) 633-7250

Specialties & licenses 2

Addresses

Other names 1

• StateServ Medical LLC Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1013291657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 S. ALMA SCHOOL ROAD",
            "address_2": "SUITE 4000",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85210",
            "telephone_number": "336-227-8030",
            "fax_number": "336-227-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26100 SW 95TH AVE",
            "address_2": "SUITE 200",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "97070",
            "telephone_number": "503-729-2371",
            "fax_number": "503-598-9737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATESERV MEDICAL OF OREGON, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE STATESERV COMPANIES LLC",
        "enumeration_date": "2011-09-30",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "ROODE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "877-633-7250"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OR",
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "OR",
            "license": "NPC-0003526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "StateServ Medical LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "StateServ Medical LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Matthew Stahl, OT
• David Patrick Standiford, BS
• Aimee Stanton
• John Stanton
• Austin James Stapleton
• Holly Steidlmayer, PTA
• Linda Marie Stenberg, MS, LPC
• Deveron Stephen
• Amanda Stepp
• Keslee Marie Stevenson

• Durable Medical Equipment & Medical Supplies in Wilsonville, OR
• Providers in Wilsonville, OR by specialty
• Durable Medical Equipment & Medical Supplies in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.