MR. LARRY ALLEN PADDOCK CSFA NPI 1174115026

NPI Information

NPI: 1174115026
Provider Name: MR. LARRY ALLEN PADDOCK, CSFA
Classification: Specialist/Technologist, Other - 246ZC0007X
Specialization: Surgical Assistant
Entity Type: Individual
Address: 2700 SE STRATUS AVE
MCMINNVILLE, OR
ZIP 97128
Phone: (503) 435-6580

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NPI Details

MR. Larry Allen Paddock, CSFA is a surgical assistant specialist technologist other in Mcminnville, OR. The provider is a surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. MR. Larry Allen Paddock, CSFA NPI is 1174115026. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2700 SE STRATUS AVE
MCMINNVILLE, OR
ZIP 97128-239
Phone: (503) 435-6580

The enumeration date for this NPI number is 2/10/2021 and was last updated on 2/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	246ZC0007X	Specialist/Technologist, Other	Surgical Assistant			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	199390	OTHER		NATIONAL BOARD OF SURGICAL TECHNOLOGY AND SURGICAL ASSISTING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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