| Katherine Bucciantini, AGPCNP, ANP | |
| 
					12670 Nw Barnes Rd Ste 100, Portland, OR 97229-9001  | |
| (503) 648-9565 | |
| (503) 648-1282 | 
| Full Name | Katherine Bucciantini | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Adult Health | 
| Location | 12670 Nw Barnes Rd Ste 100, Portland, Oregon | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1215346929 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | 201402157NP-PP (Oregon) | Primary | 
| Entity Name | The Wallace Medical Concern | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1841592110 PECOS PAC ID: 2365680865 Enrollment ID: O20150224001107  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Katherine Bucciantini, AGPCNP, ANP 12670 Nw Barnes Rd Ste 100, Portland, OR 97229-9001 Ph: (503) 648-9565  | Katherine Bucciantini, AGPCNP, ANP 12670 Nw Barnes Rd Ste 100, Portland, OR 97229-9001 Ph: (503) 648-9565  | 
Mrs. Anjalee Nix Rowe, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-3988  | |
Ms. Susan Irene Smith, RN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5100 Sw Macadam Ave, Suite 200, Portland, OR 97239 Phone: 971-202-5500 Fax: 971-202-5555  | |
Iva Juric,  Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239 Phone: 503-494-4808  | |
Ms. Jessica A Dudley, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3550 N Interstate Ave, Portland, OR 97227 Phone: 503-746-1575  | |
Summer Morgan Massina, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 721 Nw 9th Ave Ste 100, Portland, OR 97209 Phone: 503-525-0090  | |
Dr. Jeffery Wise, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1220 Sw Morrison St Ste 730, Portland, OR 97205 Phone: 971-354-9242  | |
A'lissa Richards, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12121 E Burnside St, Portland, OR 97216 Phone: 971-361-7700  |