NW PEDIATRICS INTEGRATIVE MEDICINE
NPI 1033832589
Clinic/Center - Primary Care in Portland, OR

Active since September 20, 2022CLIA 38D1085645 · Waiver
11790 SW BARNES RD STE 140, PORTLAND, OR 97225(503) 643-2100 Get Directions Write a Review

NPPES record last updated: October 18, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 18, 2023, Aug 23, 2023, Sep 20, 2022 (3 updates tracked since 2022).

About Nw Pediatrics Integrative Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NW PEDIATRICS INTEGRATIVE MEDICINE (NPI 1033832589) is a healthcare organization registered as a primary care in Portland, Oregon and active in the NPI registry since September 2022. The organization holds a CLIA Waiver certificate valid through December 4, 2026 and lists Tanya Markle, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1033832589
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameNW PEDIATRICS INTEGRATIVE MEDICINE LLC
Location Address11790 SW BARNES RD STE 140Portland, OR 97225-5938
Mailing Address11790 Sw Barnes Rd Ste 140Portland, OR 97225-5938 · (503) 643-2100
Organization SubpartNo
Authorized OfficialTanya MarklePractice Manager · (503) 616-5665
Enumeration DateSeptember 20, 2022
Last NPPES UpdateOctober 18, 20233 updates tracked since enumeration
NPPES CertifiedOctober 18, 2023
NPI 1033832589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedPediatricsTaxonomy 208000000X
11790 SW BARNES RD STE 140, Portland, OR 97225

Other Names 1

Doing Business AsNw Pediatrics Integrative Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 38D1085645

NW Pediatrics Integrative Medicine · Portland, OR
Active · expires Dec 4, 2026
CLIA Number38D1085645
Laboratory TypePractitioner Other
Certificate Effective DateDecember 5, 2024
Certificate Expiration DateDecember 4, 2026
Laboratory DirectorShaudine R. Woody
Laboratory Phone(503) 643-2100
Laboratory LocationNW Pediatrics Integrative Medicine11790 SW Barnes Rd Bldg A Ste 140, Portland, OR 97225
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
11790 SW BARNES RD STE 140
PORTLAND, OR 97225
Nurse Practitioner (Pediatrics)
11790 SW BARNES RD STE 140
PORTLAND, OR 97225
Physician Assistant
11790 SW BARNES RD STE 140
PORTLAND, OR 97225
Pediatrics
11790 SW BARNES RD STE 140
PORTLAND, OR 97225

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is NW Pediatrics Integrative Medicine LLC's NPI number?

The NPI number for NW Pediatrics Integrative Medicine LLC is 1033832589. It was assigned to this organization in the NPPES registry on September 20, 2022. The provider is doing business as NW Pediatrics Integrative Medicine.

Where is NW Pediatrics Integrative Medicine LLC located?

NW Pediatrics Integrative Medicine LLC is located at 11790 SW Barnes Rd Ste 140, Portland, OR 97225. The listed phone number is (503) 643-2100.

What is NW Pediatrics Integrative Medicine LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does NW Pediatrics Integrative Medicine LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D1085645) is associated with this NPI, valid through December 4, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does NW Pediatrics Integrative Medicine LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list NW Pediatrics Integrative Medicine LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for NW Pediatrics Integrative Medicine LLC was last updated on October 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.