Basic Information
| Provider Information | |||||||||
| NPI: | 1053847442 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TOMES | ||||||||
| FirstName: | PAIGE | ||||||||
| MiddleName: | FRANCES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PIPER | ||||||||
| OtherFirstName: | PAIGE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 668 MCVEY AVE UNIT 41 | ||||||||
| Address2: | |||||||||
| City: | LAKE OSWEGO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970344813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9892252087 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1233 EDGEWATER ST NW | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973044049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033787526 | ||||||||
| FaxNumber: | 5034801611 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2017 | ||||||||
| LastUpdateDate: | 09/15/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 09/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 10983219-1205 | UT | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | 10983219-1205 | UT | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208000000X | MD206116 | OR | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | MD206116 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.