Aaa Health Services, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

AAA HEALTH SERVICES, LLC

Practice address

12774 SE Stark St
Portland, OR 97233-1539

Phone

(503) 567-6077

Fax

(503) 994-0341

NPI assigned

Dec 5, 2020

Last updated

Dec 5, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Volodymyr Golovan

Title

Manager

Phone

(503) 567-6077

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1607126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607126400000",
    "number": "1295331304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12774 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "503-567-6077",
            "fax_number": "503-994-0341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12774 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972331539",
            "telephone_number": "503-567-6077",
            "fax_number": "503-994-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AAA HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-05",
        "last_updated": "2020-12-05",
        "certification_date": "2020-12-05",
        "status": "A",
        "authorized_official_last_name": "GOLOVAN",
        "authorized_official_first_name": "VOLODYMYR",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-567-6077",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2020; 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.