| Alyssa Peterson, PA-C | |
|
1350 Ne 122nd Ave Ste 200, Portland, OR 97230-2011 | |
| (503) 408-7008 | |
| (503) 408-7045 |
| Full Name | Alyssa Peterson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 3 Years |
| Location | 1350 Ne 122nd Ave Ste 200, Portland, Oregon |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336903954 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA219368 (Oregon) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Icco Llc | 1355406729 | 133 |
| Entity Name | Icco LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407004757 PECOS PAC ID: 1355406729 Enrollment ID: O20090218000510 |
| Mailing Address | Practice Location Address |
|---|---|
| Alyssa Peterson, PA-C 1350 Ne 122nd Ave, Portland, OR 97230-2011 Ph: Not Available | Alyssa Peterson, PA-C 1350 Ne 122nd Ave Ste 200, Portland, OR 97230-2011 Ph: (503) 408-7008 |
James Francis Deitle, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 501 N Graham St, Suite #580, Portland, OR 97227 Phone: 503-528-0704 Fax: 503-528-0708 |
David Pritchett, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1535 N Williams Ave, Portland, OR 97227 Phone: 503-238-2067 |
Cindy M Fulton, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4400 Ne Halsey St Ste 102, Portland, OR 97213 Phone: 503-962-1000 |
Kathleen Irene Rodenburg, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 11782 Sw Barnes Rd Ste 300, Portland, OR 97225 Phone: 503-214-5200 Fax: 503-906-6613 |
Molly Anderson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-4910 |
Kayla Mae Eversole, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1815 Sw Marlow Ave Ste 100, Portland, OR 97225 Phone: 503-935-8100 Fax: 503-935-8110 |
Mackenzie Jean Eikamp, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-1620 Fax: 503-494-6670 |