Nicholas Madden Grasvik, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

8986 Issued in OR

Practice address

16230 SE McLoughlin Blvd
Milwaukie, OR 97267-4657

Phone

(503) 654-9565

Fax

(503) 654-0472

NPI assigned

Aug 14, 2007

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1225220122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16230 SE MCLOUGHLIN BLVD",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972674657",
            "telephone_number": "503-654-9565",
            "fax_number": "503-654-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16230 SE MCLOUGHLIN BLVD",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972674657",
            "telephone_number": "503-654-9565",
            "fax_number": "503-654-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRASVIK",
        "first_name": "NICHOLAS",
        "middle_name": "MADDEN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "8986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Gotfredson, CO,BOCP
• Aline Gottlieb, MD, PHD
• Julie Kathleen Gould, PHYSICAL THERAPIST
• Crystal Graber
• Kimberly Grahn
• Celesta Graves, REGISTERED NURSE
• Jeffrey Jay Graves, RPH
• Sandra Lynne Graves
• Eeva S Gray, RD, CDE
• Green Lotus Acupuncture, LLC

• Dentist in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.