| Ella Clark-nicholson, PA-C | |
|
3303 Sw Bond Ave, Portland, OR 97239-4501 | |
| (503) 494-8573 | |
| (503) 494-3457 |
| Full Name | Ella Clark-nicholson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 20 Years |
| Location | 3303 Sw Bond Ave, 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 |
|---|---|---|---|
| 1396817458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA01168 (Oregon) | Secondary |
| 363AM0700X | Physician Assistant - Medical | (NU) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ohsu Hospital And Clinics | Portland, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| University Professional Services | 4880760107 | 1683 |
| Entity Name | Oregon Health & Science University |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417969304 PECOS PAC ID: 1759328842 Enrollment ID: O20050516000173 |
| Entity Name | University Professional Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376709535 PECOS PAC ID: 4880760107 Enrollment ID: O20080910000013 |
| Mailing Address | Practice Location Address |
|---|---|
| Ella Clark-nicholson, PA-C 3906 Sw Kanan Dr, Portland, OR 97221-3433 Ph: (206) 617-4095 | Ella Clark-nicholson, PA-C 3303 Sw Bond Ave, Portland, OR 97239-4501 Ph: (503) 494-8573 |
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 |
Samuel Bryan Valdivia, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 501 N Graham St Medical Office Building 2, Suite 220, Portland, OR 97227 Phone: 503-413-6200 |