| Mr Micah S Bicker, PA-C | |
|
535 Ne 6th Ave, Estacada, OR 97023-9312 | |
| (503) 630-8550 | |
| Not Available |
| Full Name | Mr Micah S Bicker |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 535 Ne 6th Ave, Estacada, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518053511 | NPI | - | NPPES |
| R188820 | Other | OR | MEDICARE PTAN |
| 100427720B | Medicaid | KS | |
| 1518053511 | Medicaid | WA | |
| 500710332 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | PA (Oregon) | Secondary |
| 363A00000X | Physician Assistant | 0325344 (Kansas) | Secondary |
| 363A00000X | Physician Assistant | PA175642 (Oregon) | Primary |
| Entity Name | Legacy Clinics LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902827272 PECOS PAC ID: 0244144004 Enrollment ID: O20031117000089 |
| Entity Name | Silverton Health |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669424354 PECOS PAC ID: 8921901877 Enrollment ID: O20040129000172 |
| Entity Name | Icco LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407004757 PECOS PAC ID: 1355406729 Enrollment ID: O20090218000510 |
| Entity Name | Carelon Medical Partners PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124443403 PECOS PAC ID: 9931332111 Enrollment ID: O20200910002921 |
| Entity Name | Western Healthcare Services Texas |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336878024 PECOS PAC ID: 7911388202 Enrollment ID: O20220718002665 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Micah S Bicker, PA-C 4555 N Williams Ave, Portland, OR 97217-2955 Ph: (971) 373-4165 | Mr Micah S Bicker, PA-C 535 Ne 6th Ave, Estacada, OR 97023-9312 Ph: (503) 630-8550 |