| Tiffany Petterborg, PA-C | |
|
5289 Ne Elam Young Pkwy Ste 150, Hillsboro, OR 97124-7551 | |
| (971) 353-4925 | |
| (833) 450-6378 |
| Full Name | Tiffany Petterborg |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 1 Years |
| Location | 5289 Ne Elam Young Pkwy Ste 150, Hillsboro, 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 |
|---|---|---|---|
| 1457841397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA221939 (Oregon) | Primary |
| 146N00000X | Emergency Medical Technician, Basic | (NU) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ashley Regional Medical Center | Vernal, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ashley Valley Physician Practice Llc | 4284683947 | 20 |
| Chidimma Abanulo, Md, Llc | 3072961978 | 3 |
| Entity Name | Ashley Valley Physician Practice LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740482025 PECOS PAC ID: 4284683947 Enrollment ID: O20050119001166 |
| Entity Name | Vernal Urgent Care LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376012336 PECOS PAC ID: 5193149086 Enrollment ID: O20200724001464 |
| Mailing Address | Practice Location Address |
|---|---|
| Tiffany Petterborg, PA-C 5289 Ne Elam Young Pkwy Ste 150, Hillsboro, OR 97124-7551 Ph: (971) 353-4925 | Tiffany Petterborg, PA-C 5289 Ne Elam Young Pkwy Ste 150, Hillsboro, OR 97124-7551 Ph: (971) 353-4925 |
Ms. Mari Kresge Alexander, PA-C, LMFT Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 226 Se 8th Ave, Hillsboro, OR 97123 Phone: 503-601-7400 Fax: 503-601-7311 |
Lauren Melissa Small, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 19075 Nw Tanasbourne Dr, Suite 200, Hillsboro, OR 97124 Phone: 503-684-8252 |
Heather N Davidson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10670 Ne Cornell Rd Ste 300, Hillsboro, OR 97124 Phone: 503-216-9300 |
Jessica Jean Aikin, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 333 Se 7th Ave Ste 4350, Hillsboro, OR 97123 Phone: 503-844-8220 Fax: 503-844-8234 |
Tarisa Olinski, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4660 Ne Belknap Ct Ste 119, Hillsboro, OR 97124 Phone: 503-359-3809 Fax: 503-359-3809 |
John Kenneth Glenn, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2460 Ne Griffin Oaks St, Suite D1000, Hillsboro, OR 97124 Phone: 360-213-1301 |
Jessica Evonne Dumitru, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 421 Se Washington St, Hillsboro, OR 97123 Phone: 503-352-1141 Fax: 503-352-1147 |