Eward Allen Grossenbacher, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

OR7578 Issued in OR

Practice address

2565 NW Lovejoy St
Suite 400
Portland, OR 97210-2996

Phone

(503) 228-4038

Fax

(503) 228-6933

NPI assigned

Apr 13, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114142593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2565 NW LOVEJOY ST",
            "address_2": "SUITE 400",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102996",
            "telephone_number": "503-228-4038",
            "fax_number": "503-228-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 NW LOVEJOY ST",
            "address_2": "SUITE 400",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102996",
            "telephone_number": "503-228-4038",
            "fax_number": "503-228-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSENBACHER",
        "first_name": "EWARD",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "OR7578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Clark Grossart, LMT, CERT ADV ROLFER
• Aaron Grossberg, MD, PHD
• Emily Rose Grossberg, LPC
• Lars Grosse-Wortmann, MD
• Savannah Grosse, DPT
• Lisa Grossenbacher
• Nancy L Grossenbacher, OTR
• Ryan Grossenbacher
• Joshua A Grosser, MD
• Brandon Russell Grosshart, DO

• Specialist in Portland, OR
• Providers in Portland, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.