MEDICARE: NORTHWEST ENDOCRINOLOGY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	MD28838	OR

General Provider Information

NPI Number	:	1619273844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST ENDOCRINOLOGY, LLC

Provider Business Mailing Address
First Line	:	328 SW HAMILTON ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-4036
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16463 BOONES FERRY RD
Second Line	:	SUITE 300
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-4259
Country	:	US
Telephone Number	:	503-303-8377
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TROY DILLARD
Credential	:	M.D.
Telephone Number	:	503-897-0403

Provider Enumeration Date	:	02/05/2011
Last Update Date	:	03/08/2011

Similar Medicare Providers

1720787203 — MRS. SUSAN MERIE COLEMER A-GNP-C
Practice Location Address:

16463 BOONES FERRY RD
LAKE OSWEGO, OR
97035-4259

Practice Phone: 541-748-9634
Practice Fax:

1992841555 — MRS. JANICE CAROLE MODESITT L.M.T.
Practice Location Address:

16463 BOONES FERRY RD
LAKE OSWEGO, OR
97035-4259

Practice Phone: 503-699-2955
Practice Fax:

1295978732 — STEVEN A. HASHIGUCHI, MD, LLC
Practice Location Address:

16463 BOONES FERRY RD , #300
LAKE OSWEGO, OR
97035-4259

Practice Phone: 503-635-6256
Practice Fax: 503-636-9604

1558505032 — ELIZABETH GRAFF M.D.
Practice Location Address:

16463 BOONES FERRY RD , SUITE 400
LAKE OSWEGO, OR
97035-4259

Practice Phone: 503-635-3743
Practice Fax: 503-635-1508

1639438419 — JANICE MODESITT LMT
Practice Location Address:

16463 BOONES FERRY RD , STE. 100
LAKE OSWEGO, OR
97035-4259

Practice Phone: 503-699-2955
Practice Fax:

1588902902 — OLSON PEDIATRIC CLINIC, LLC
Practice Location Address:

16463 BOONES FERRY RD , SUITE 400
LAKE OSWEGO, OR
97035-4259

Practice Phone: 503-635-3743
Practice Fax: 503-636-7404

Directions to “NORTHWEST ENDOCRINOLOGY, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.