Healthcare Provider Details

I. General information

NPI: 1588135180
Provider Name (Legal Business Name): PARADIGM PROFESSIONAL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2018
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12725 SW MILLIKAN WAY STE 300
BEAVERTON OR
97005-1687
US

IV. Provider business mailing address

12725 SW MILLIKAN WAY STE 300
BEAVERTON OR
97005-1687
US

V. Phone/Fax

Practice location:
  • Phone: 503-906-7928
  • Fax:
Mailing address:
  • Phone: 503-906-7928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIAHM STEPHENSON
Title or Position: PRESIDENT
Credential:
Phone: 971-706-9524