Steven Wayne Mikalson, LMT

Primary specialty

Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081N0008X

License

4298 Issued in OR

Practice address

4004 SW Kelly Ave
Suite 204
Portland, OR 97239-4389

Phone

(503) 241-4757

NPI assigned

Feb 23, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Steven W Mikalson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424649600000",
    "number": "1851783252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 SW KELLY AVE",
            "address_2": "SUITE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 SW KELLY AVE",
            "address_2": "SUITE 204",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394389",
            "telephone_number": "503-241-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKALSON",
        "first_name": "STEVEN",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081N0008X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "OR",
            "license": "4298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEVEN",
            "last_name": "MIKALSON",
            "middle_name": "W",
            "prefix": "MR.",
            "credential": "LMT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Roberta L Mihara, PSYD
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• Paige Y Miho, DC
• Stephanie Mijo
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• Mike Moody LLC
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• Max Mikelson
• Clara Mikhaeil, PHARMD
• Mariya Mikhaylova

• Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician in Portland, OR
• Providers in Portland, OR by specialty
• Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.