East Portland Ear Nose and Throat Clinic

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

EAST PORTLAND EAR NOSE AND THROAT CLINIC

Practice address

24076 SE Stark St
Suite 230
Gresham, OR 97030-3373

Phone

(503) 465-5461

Fax

(503) 465-5468

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Roger J Wobig, M.D.NPI 1649245499

Title

Partner

Phone

(503) 465-5461

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Roger John Wobig, M.D.

  • Otolaryngology Physician
  • Gresham, OR
  • NPI 1649245499
  NPD (past) Authorized official

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1730257940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "SUITE 230",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-465-5461",
            "fax_number": "503-465-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24076 SE STARK ST",
            "address_2": "SUITE 230",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303373",
            "telephone_number": "503-465-5461",
            "fax_number": "503-465-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PORTLAND EAR NOSE AND THROAT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WOBIG",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "503-465-5461",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifford Ray Dusky, CRM II, PWS, THW,
• Ashley Rae Duvall, DPT
• Jasmina Dzafic, MA, CADC I CANDIDATE
• Hannah Earley, MSW
• John T Early, FNP-C
• Ramona East, CPT
• Hailey Eastep
• Stephanie Eastin, L.AC.
• Eastside Allergy Asthma & General Internal Medicine PC
• Eastside Child and Family Therapy, LLC

• Specialist in Gresham, OR
• Providers in Gresham, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.