Goldmark Wound Specialty Group Deschutes, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GOLDMARK WOUND SPECIALTY GROUP DESCHUTES, LLC

Practice address

7150 SW Hampton St Ste 101
Tigard, OR 97223-8365

Phone

(971) 236-4445

Fax

(971) 236-4445

NPI assigned

Nov 22, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Heidi Hagman, MDNPI 1962489575

Title

Owner/ Medical Director

Phone

(971) 910-3888

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Heidi M Hagman, M.D.

  • Internal Medicine Physician
  • Tigard, OR
  • NPI 1962489575
  NPD Authorized official
• Kathleen Patricia Kerwan, FNP-C

  • Family Nurse Practitioner
  • Tigard, OR
  • NPI 1902835838
  NPD
• Adeline E Hij, APRN FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
  • NPI 1225852148
  NPD

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1356166482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7150 SW HAMPTON ST STE 101",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238365",
            "telephone_number": "971-236-4445",
            "fax_number": "971-236-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 SW HAMPTON ST STE 101",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238365",
            "telephone_number": "971-236-4445",
            "fax_number": "971-236-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDMARK WOUND SPECIALTY GROUP DESCHUTES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "HAGMAN",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "OWNER/ MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "971-910-3888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Munyaradzi Gocha
• Walter Paul Goebel, MD
• Laura Amrofell Goff, L.AC.
• Stephen Andrew Goins
• Brooke Sheila Golden, BSW
• Goldmark Wound Specialty Group Mpo, LLC
• Goldmark Wound Specialty Group PDX, LLC (Regencare Wound Care Providers PDX)
• Enrique Gomez Morayta, M.D.
• Trinidad Lavone Gomez-Michael
• Maureen Matthews Gonzales, PT

• Family Medicine Physician in Tigard, OR
• Providers in Tigard, 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 Nov 22, 2024; 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.