Savage Classy Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SAVAGE CLASSY INC

Practice address

6464 SW Borland Rd Ste C5
Tualatin, OR 97062-8856

Phone

(503) 878-5412

Fax

(888) 972-9515

NPI assigned

Jul 27, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Heather Dryden, MD

Title

Labortatory Director

Phone

(503) 878-5412

Specialties & licenses 1

Addresses

Other names 1

• STELLAR LABS NW Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Frank Capobianco, CPT

  • Phlebotomy Technician
  • Tualatin, OR
  • NPI 1437773298
  NPD

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627344000000",
    "number": "1497428379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6464 SW BORLAND RD STE C5",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628856",
            "telephone_number": "503-878-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6464 SW BORLAND RD STE C5",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628856",
            "telephone_number": "503-878-5412",
            "fax_number": "888-972-9515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAVAGE CLASSY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-27",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "DRYDEN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "LABORTATORY DIRECTOR",
        "authorized_official_telephone_number": "503-878-5412",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STELLAR LABS NW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Krisstal Santiago, MSC, ACC, LMT, CST
• Sara Wood, ND LLC
• Kwadwo Sarfo Gyamfi
• Sarra Borhanian MD LLC
• Mohammad Reza Sasan, RPH
• Jeffrey Robert Savage, LAC, DACM
• Jennifer Savory, PHARMD
• Natalie Anne Scandurro, MS, RD, CSP, LD
• James B Schader, MD
• Justin Robert Scheckler, PTA, BS

• Clinical Medical Laboratory in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Clinical Medical Laboratory in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.