| Annette N Sampson, | |
|
9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 | |
| (503) 879-2002 | |
| (503) 879-2071 |
| Full Name | Annette N Sampson |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 9605 Grand Ronde Rd, Grand Ronde, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215241708 | NPI | - | NPPES |
| 171037 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 201141804RN (Oregon) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 202214454NP-PP (Oregon) | Primary |
| Entity Name | Confederated Tribes Of The Grand Ronde Community Of Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174666358 PECOS PAC ID: 6103717277 Enrollment ID: O20040320000494 |
| Mailing Address | Practice Location Address |
|---|---|
| Annette N Sampson, 9615 Grand Ronde Rd, Grand Ronde, OR 97347-9712 Ph: (503) 879-2002 | Annette N Sampson, 9605 Grand Ronde Rd, Grand Ronde, OR 97347-9712 Ph: (503) 879-2002 |
Mr. Maurice A Ajaifia, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9605 Grand Ronde Rd, Grand Ronde, OR 97347 Phone: 503-879-2026 | |
Ms. Wendy Monette Schmolzi, APRN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9605 Grand Ronde Rd, Grand Ronde, OR 97347 Phone: 503-879-2002 Fax: 503-879-2071 | |
Tricia Raye Hayden, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9605 Grand Ronde Rd, Grand Ronde, OR 97347 Phone: 503-879-2060 | |
Deborah Anne Samoson, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9605 Grand Ronde Rd, Grand Ronde, OR 97347 Phone: 503-879-2002 |