Active NPI
Juliette Louise Wait, MD
- Pulmonary Disease Physician
- Portland, OR
National Provider Identifier
1073561650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MD24778
- Practice address
- 9427 SW Barnes Rd Ste 296
Portland, OR 97225-6667 - Phone
- (503) 297-3778
- Fax
- (503) 297-7853
- NPI assigned
- May 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | H3197 | TX | |
| Pulmonary Disease Physician | 207RP1001X | H3197 | TX | |
| Pulmonary Disease Physician | 207RP1001X | MD24778 | OR | Primary |
Addresses
Primary practice location
9427 SW Barnes Rd Ste 296
Portland, OR 97225-6667
Mailing address
847 NE 19TH Ave
Suite 300
Portland, OR 97232-2684
Phone (503) 963-2801
Other practice location 1
19250 SW 65th Ave Ste 135
Tualatin, OR 97062-7745
Phone (503) 692-8560
Other practice location 2
16770 SW Edy Rd Ste 216
Sherwood, OR 97140-9679
Phone (503) 297-3778
Other practice location 3
879 Providence Dr
Newberg, OR 97132-7563
Phone (503) 297-3778
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500707189 | Medicaid | OR | |
| P00881737 | Other | TX | RAILROAD MEDICARE |
| 117055704 | Medicaid | TX | |
| 2059836 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1073561650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "847 NE 19TH AVE",
"address_2": "SUITE 300",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322684",
"telephone_number": "503-963-2801",
"fax_number": "503-963-2825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9427 SW BARNES RD STE 296",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972256667",
"telephone_number": "503-297-3778",
"fax_number": "503-297-7853"
}
],
"practiceLocations": [
{
"address_1": "19250 SW 65th Ave Ste 135",
"address_purpose": "LOCATION",
"city": "Tualatin",
"state": "OR",
"postal_code": "970627745",
"country_code": "US",
"telephone_number": "503-692-8560",
"fax_number": "503-692-8562",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "16770 SW Edy Rd Ste 216",
"address_purpose": "LOCATION",
"city": "Sherwood",
"state": "OR",
"postal_code": "971409679",
"country_code": "US",
"telephone_number": "503-297-3778",
"fax_number": "503-297-7853",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "879 Providence Dr",
"address_purpose": "LOCATION",
"city": "Newberg",
"state": "OR",
"postal_code": "971327563",
"country_code": "US",
"telephone_number": "503-297-3778",
"fax_number": "503-297-7853",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAIT",
"first_name": "JULIETTE",
"middle_name": "LOUISE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-05",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "TX",
"license": "H3197",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "TX",
"license": "H3197",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "OR",
"license": "MD24778",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500707189",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00881737",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "117055704",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2059836",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.