| Jeffrey Allan Koller, PA-C | |
|
114 Se Church St, Sublimity, OR 97385-9424 | |
| (503) 769-2259 | |
| Not Available |
| Full Name | Jeffrey Allan Koller |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 3 Years |
| Location | 114 Se Church St, Sublimity, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215790639 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA218511 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Santiam Hospital & Clinics | Stayton, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Santiam Memorial Hospital | 6103729751 | 128 |
| Robert Olsen Md Llc | 7517354517 | 25 |
| Entity Name | Santiam Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154302214 PECOS PAC ID: 6103729751 Enrollment ID: O20040130000239 |
| Entity Name | Robert Olsen MD LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902565930 PECOS PAC ID: 7517354517 Enrollment ID: O20220421000922 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey Allan Koller, PA-C 114 Se Church St, Sublimity, OR 97385-9424 Ph: (503) 769-2259 | Jeffrey Allan Koller, PA-C 114 Se Church St, Sublimity, OR 97385-9424 Ph: (503) 769-2259 |
Mr. Erin Lee Cramer, PA-C, ATC Physician Assistant Medicare: Medicare Enrolled Practice Location: 114 Se Church St, Sublimity, OR 97385 Phone: 503-769-2259 Fax: 503-769-8049 |
Michael Bass, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 114 Se Church St, Sublimity, OR 97385 Phone: 503-769-2259 Fax: 503-769-8049 |