Healthcare Provider Details

I. General information

NPI: 1164765590
Provider Name (Legal Business Name): CASEY STERLING WARD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2013
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3377 RIVERBEND DR
SPRINGFIELD OR
97477-8803
US

IV. Provider business mailing address

501 N GRAHAM ST STE 265
PORTLAND OR
97227-2000
US

V. Phone/Fax

Practice location:
  • Phone: 541-222-8500
  • Fax: 541-222-6435
Mailing address:
  • Phone: 503-280-1286
  • Fax: 503-280-1290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA142143
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD191055
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: