Nathalie Van Havre, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD170797 Issued in OR

Practice address

9155 SW Barnes Rd
Suite 238
Portland, OR 97225-6625

Phone

(503) 223-7214

Fax

(503) 227-7572

NPI assigned

Jun 1, 2015

Last updated

Jun 1, 2015By the provider in NPPES

Sex

Female

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 OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  Internal Medicine

  Medicare reassignment NPD
• Legacy Clinics LLC

  dba Legacy Medical Group Firwood

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD (past)
• Westside Internal Medicine

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1407932098
  NPD (past)

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

{
    "created_epoch": "1433116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433116800000",
    "number": "1255711636",
    "addresses": [
        {
            "country_code": "AU",
            "country_name": "Australia",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "38 GRAY ROAD",
            "city": "WEST END",
            "state": "OLD",
            "postal_code": "4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD",
            "address_2": "SUITE 238",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256625",
            "telephone_number": "503-223-7214",
            "fax_number": "503-227-7572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HAVRE",
        "first_name": "NATHALIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-01",
        "last_updated": "2015-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD170797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Elena Van Dusen, M.D.
• Nathan Thomas Van Dyk, M.D.
• Aubrey Ann Van Dyke-Ginell, PA-C
• Alan E Van Dyke, RPH
• Cory Van Engers
• Genevieve A Van Herk, PHARM.D.
• Jonathan Reuel Van Horn, PAC
• Laura Elizabeth Van Houten, LAURA VAN HOUTEN, MD
• Erin Victoria Sneddon Van Kleek, LCSW
• Aasher Van Laer, QMHA

• Internal Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2015; 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.