Katarzyna Barbara Iwan, M.D.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

MD189597 Issued in OR

Practice address

9925 SW Nimbus Ave
#100
Beaverton, OR 97008-7591

Phone

(503) 535-8302

Fax

(855) 276-2456

NPI assigned

Apr 10, 2012

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 21, 2025 through Jul 21, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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

• PNW Spine and Joint Physicians

  • Physical Medicine & Rehabilitation Physician
  • Portland, OR
  • NPI 1316693591

  Pain Medicine

  NPD (past)

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1467718908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9925 SW NIMBUS AVE",
            "address_2": "#100",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087591",
            "telephone_number": "503-535-8302",
            "fax_number": "855-276-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9925 SW NIMBUS AVE",
            "address_2": "#100",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087591",
            "telephone_number": "503-535-8302",
            "fax_number": "855-276-2456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWAN",
        "first_name": "KATARZYNA",
        "middle_name": "BARBARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-10",
        "last_updated": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OR",
            "license": "MD189597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500753304",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Carl Isler III, PT
• Neveen Ismail, APRN
• Dylan Jitsuo Ito, DPT
• Miglena A Ivanova-Shinde
• Ivys Massage and Bodywork
• Naoya Izawa, PSY.D.
• Lisa Jackman
• Melody Jackman, MA, CMHC
• Cody Jackson, DMD
• Ian Jackson

• Pain Medicine Physician in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Pain Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.