NPIMap

Organization Active NPI

NW Allergy & Asthma Specialists,LLC

  • Allergy & Immunology Physician
  • Beaverton, OR
National Provider Identifier
1215928668
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
NW ALLERGY & ASTHMA SPECIALISTS,LLC
Practice address
4915 SW Griffith Dr Ste 304
Beaverton, OR 97005-2933
Phone
(503) 620-5614
Fax
(503) 598-4688
NPI assigned
Nov 3, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Rajeev Jain
Title
Coo
Phone
(408) 476-0624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

4915 SW Griffith Dr Ste 304
Beaverton, OR 97005-2933

Mailing address

43575 Mission Blvd Ste 716
Fremont, CA 94539-5831
Phone (408) 476-0624

Other practice location 1

10373 NE Hancock St
Portland, OR 97220-3873
Phone (971) 220-2202

Other names 1

  • Asthma Allergy Centre Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040129000292 OR Part B Supplier - Clinic/Group Practice 5496658254 Receives reassigned benefits from 8 practitioners
Practice locations: Beaverton, OR; Portland, OR

National Provider Directory

National Provider Directory

Locations

1960 NW 167th Pl
Ste 102
Aloha, OR 97006
Phone (503) 645-8427

4915 SW Griffith Dr
Ste 304
Beaverton, OR 97005
Phone (503) 620-5614

356 SE 9th Ave
Hillsboro, OR 97123
Phone (503) 647-9261

1709 NE 27th St
Ste C
McMinnville, OR 97128
Phone (503) 434-9435

435 NE Evans St
Ste 201
McMinnville, OR 97128
Phone (503) 434-9435

442 N Villa Rd
Newberg, OR 97132
Phone (503) 538-7348

420 N Villa Rd
Newberg, OR 97132
Phone (503) 538-0619

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1215928668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43575 MISSION BLVD STE 716",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945395831",
            "telephone_number": "408-476-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 SW GRIFFITH DR STE 304",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052933",
            "telephone_number": "503-620-5614",
            "fax_number": "503-598-4688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10373 NE Hancock St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972203873",
            "country_code": "US",
            "telephone_number": "971-220-2202",
            "fax_number": "888-468-7648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NW ALLERGY & ASTHMA SPECIALISTS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "RAJEEV",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "408-476-0624"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Asthma Allergy Centre",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Asthma Allergy Centre",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.