My Other Me

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

MY OTHER ME

Practice address

519 SW Park Ave Ste 304
Portland, OR 97205-3204

Phone

(503) 522-1446

NPI assigned

May 28, 2021

Last updated

Mar 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Afsari-Howard, DONPI 1356500821

Title

Founder/Ceo

Phone

(503) 522-1446

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Fariba Afsari-Howard, D.O.

  • Obstetrics & Gynecology Physician
  • Portland, OR
  • NPI 1356500821
  Medicare reassignment NPD Authorized official
• Michele Nicolette Adamcak, D.O.

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1114097227
  NPD (past)
• Khaleed Alston, ND

  • Naturopath
  • Tigard, OR
  • NPI 1609473628
  NPD (past)
• Stephen Smith Babson

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1699286153
  NPD (past)
• Karen Baltz Gibbs

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Newberg, OR
  • NPI 1598245490
  NPD (past)
• Renee Barron, FNP

  • Family Nurse Practitioner
  • Tigard, OR
  • NPI 1841720166
  NPD (past)
• Renee Michelle Beninger, CNM, FNP

  • Family Nurse Practitioner
  • Portland, OR
  • NPI 1457455917
  NPD (past)
• Michele Jean Bergmann, RN

  • Primary Care Nurse Practitioner
  • Portland, OR
  • NPI 1902166481
  NPD (past)
• Angela Marie Black, PA

  • Physician Assistant
  • Tigard, OR
  • NPI 1710063110
  NPD (past)
• Karen R Cooper, D.O.

  • Family Medicine Physician
  • Portland, OR
  • NPI 1487646238
  NPD (past)
• Simone Anna Crothers, M.A.

  • Counselor
  • Tigard, OR
  • NPI 1245403575
  NPD (past)
• Siatta Bree Dunbar, DO

  • Sports Medicine (Family Medicine) Physician
  • Albany, OR
  • NPI 1528358793
  NPD (past)

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1801462080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2343 SE 57TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972154005",
            "telephone_number": "503-522-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 SW PARK AVE STE 304",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972053204",
            "telephone_number": "503-522-1446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY OTHER ME",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-28",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "AFSARI-HOWARD",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "503-522-1446",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5006254",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faisal M Mutua
• Marcella Isabel Muysson, MD
• Kristi Muzynoski, M.S.
• Mva Dental LLC
• My Oregon Ride LLC
• Robert W.T. Myall, MD
• Amy Myer, BA
• Melinda Myer, M.A.
• Kelly Erin Myers Sugahara, LCSW
• Myers-Richards, Inc

• Gynecology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Gynecology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.