Provider Demographics
NPI:1609180009
Name:STUART E. TRENHOLME, M.D., P.C.
Entity Type:Organization
Organization Name:STUART E. TRENHOLME, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:STERNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-292-4485
Mailing Address - Street 1:9135 SW BARNES RD
Mailing Address - Street 2:#967
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6601
Mailing Address - Country:US
Mailing Address - Phone:503-292-4485
Mailing Address - Fax:503-291-7156
Practice Address - Street 1:9135 SW BARNES RD
Practice Address - Street 2:#967
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6601
Practice Address - Country:US
Practice Address - Phone:503-292-4485
Practice Address - Fax:503-291-7156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10483207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORC93965Medicare UPIN