Individual provider Active NPI

Gary Haynes, RRT

  • Registered Respiratory Therapist
  • Clackamas, OR
National Provider Identifier
1336391788
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Respiratory TherapistTaxonomy code 227900000X
License
RTP000448 Issued in OR
Practice address
10090 SE Sunnyside Rd
Clackamas, OR 97015-9764
Phone
(503) 571-3415
NPI assigned
Oct 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X RTP000448 OR Primary

Addresses

Primary practice location

10090 SE Sunnyside Rd
Clackamas, OR 97015-9764

Mailing address

2884 SE Glacier Ave
Gresham, OR 97080-9071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RTP000448ORMDRegistered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1336391788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2884 SE GLACIER AVE",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970809071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10090 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159764",
            "telephone_number": "503-571-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "GARY",
        "credential": "RRT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": "OR",
            "license": "RTP000448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.