Pacific Kidney & Hypertension, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PACIFIC KIDNEY & HYPERTENSION, LLC

Practice address

232 NE Norton LN
McMinnville, OR 97128-8470

Phone

(503) 434-1159

Fax

(503) 434-1190

NPI assigned

Nov 19, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Giullian, MDNPI 1073660932

Title

Owner

Phone

(855) 397-0197

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Oregon Kidney & Hypertension Clinic Doing business as

Locations

Practitioners 8

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

• Jeffrey A Giullian, M.D.

  • Nephrology Physician
  • Denver, CO
  • NPI 1073660932
  NPD Authorized official
• Josef Edrik Keith Abiog Bautista, MD

  • Nephrology Physician
  • Everett, WA
  • NPI 1700131125
  NPD
• Katrina Carli, M.D.

  • Nephrology Physician
  • Everett, WA
  • NPI 1407112337
  NPD
• Stefania Marie Lew, NP

  • Nurse Practitioner
  • Honolulu, HI
  • NPI 1225265556
  NPD
• Oliver Shu-on Tai, MD

  • Nephrology Physician
  • Everett, WA
  • NPI 1699885731
  NPD
• Noemie Corinne Juaire, M.D.

  • Nephrology Physician
  • Everett, WA
  • NPI 1518196542
  NPD (past)
• I Pan, APRN

  • Nurse Practitioner
  • Kent, WA
  • NPI 1922565795
  NPD (past)
• Michael Jordan Borja Pastor, DNP, ARNP, FNP-BC

  • Nurse Practitioner
  • Everett, WA
  • NPI 1275274698
  NPD (past)

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

{
    "created_epoch": "1384819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1679903231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 E RAY RD STE B201",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852258720",
            "telephone_number": "855-397-0197",
            "fax_number": "800-272-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 NE NORTON LN",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288470",
            "telephone_number": "503-434-1159",
            "fax_number": "503-434-1190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24900 SE Stark St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Gresham",
            "state": "OR",
            "postal_code": "970303382",
            "country_code": "US",
            "telephone_number": "503-284-1937",
            "fax_number": "503-284-3908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15895 SW 72nd Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972247966",
            "country_code": "US",
            "telephone_number": "503-624-5630",
            "fax_number": "503-624-9149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 N Providence Dr Ste 320",
            "address_purpose": "LOCATION",
            "city": "Newberg",
            "state": "OR",
            "postal_code": "971327582",
            "country_code": "US",
            "telephone_number": "503-434-1159",
            "fax_number": "503-434-1190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PACIFIC KIDNEY & HYPERTENSION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-19",
        "last_updated": "2023-11-02",
        "certification_date": "2021-02-16",
        "status": "A",
        "authorized_official_last_name": "GIULLIAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-397-0197",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500689878",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2079319",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oregon Kidney & Hypertension Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalie Osborne
• Sienna Maria Osborne
• Osprey Alf, LLC
• Osprey Court
• Launa Marie Ottele
• Pacific Northwest Psychology Associates
• Pacific Northwest Renal Services, L.L.C.
• Pacifica SL McMinnville LLC
• Roberta S Packard, RN
• Larry Allen Paddock Jr., CSFA

• Nephrology Physician in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Nephrology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.