| Ms Stacey M Campbell, PA-C | |
|
1151 May St, Suite 201, Hood River, OR 97031-1526 | |
| (541) 387-1300 | |
| (541) 386-6224 |
| Full Name | Ms Stacey M Campbell |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 1151 May St, Hood River, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942389408 | NPI | - | NPPES |
| P00630499 | Other | OR | RR MEDICARE (PH&S)-PMG |
| 500600089 | Medicaid | OR | |
| 8416539 | Medicaid | WA | |
| 0142139 | Other | WA | WA STATE D L&I NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA10004739 (Washington) | Secondary |
| 363A00000X | Physician Assistant | PA01196 (Oregon) | Primary |
| Entity Name | Providence Health & Services Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023488343 PECOS PAC ID: 0648183608 Enrollment ID: O20031106000652 |
| Entity Name | Providence Health & Services Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053862714 PECOS PAC ID: 7315856010 Enrollment ID: O20040304001330 |
| Entity Name | Columbia Gorge Medical Center PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558346064 PECOS PAC ID: 8628066115 Enrollment ID: O20040504000398 |
| Entity Name | Providence Health & Services Oregon |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1255429338 PECOS PAC ID: 7315856010 Enrollment ID: O20061104000324 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Stacey M Campbell, PA-C Po Box 3390, Portland, OR 97208-3390 Ph: Not Available | Ms Stacey M Campbell, PA-C 1151 May St, Suite 201, Hood River, OR 97031-1526 Ph: (541) 387-1300 |
Mrs. Ana Lucia Jensen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1750 12th St, Hood River, OR 97031 Phone: 541-386-5070 |
Jenny Harris, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 849 Pacific Ave, Hood River, OR 97031 Phone: 541-386-6380 Fax: 541-386-1078 |
Audrey Howarth, PA-C Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 1750 12th St, Hood River, OR 97031 Phone: 919-323-9803 |
Clarabel Deleon, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1021 June St, Hood River, OR 97031 Phone: 541-386-3626 |
Ms. Holly Bliss Tumelson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1010 10th St, Hood River, OR 97031 Phone: 541-386-9500 Fax: 541-386-9500 |
Mr. Robert James Fiske, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1021 June St, Hood River, OR 97031 Phone: 541-386-3626 Fax: 541-386-3775 |
Jonathan Daniel Farrell, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1010 10th St, Hood River, OR 97031 Phone: 541-386-9500 |