Paul J Deitering (NPI# 1598701690, PAC ID# 1052396207) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1598701690 |
| PAC ID by PECOS | 1052396207 |
| Professional Enrollment ID | I20040622000319 |
| Full Name | Paul J Deitering |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES OREGON |
| Address |
9290 Se Sunnybrook Blvd Suite 120 Clackamas OR 97015-6802 |
| Phone Number | 5032152110 |
| Gender | M |
| Credential | PA |
| Graduation Year | 2000 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 0648183608 |
| Number of Group Practice Members | 1163 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380004 | PROVIDENCE ST VINCENT MEDICAL CENTER |
| 380037 | PROVIDENCE NEWBERG MEDICAL CENTER |
| 380061 | PROVIDENCE PORTLAND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 | 5032152110 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 1003 Providence Dr, Suite 210, Newberg, OR 97132-7523 | 5035375900 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 1003 Providence Dr, Suite 310, Newberg, OR 97132-7524 | 5035376040 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 1321 Ne 99th Ave, 200 Gateway Fam and Com Me, Portland, OR 97220-9439 | 5032154250 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 4805 Ne Glisan, Portland, OR 97213-2933 | PROVIDENCE HEALTH AND SERVICES OREGON | |
| 4805 Ne Glisan St, Portland, OR 97213-2933 | PROVIDENCE HEALTH AND SERVICES OREGON | |
| 5050 Ne Hoyt, 454 Providence Med Group, Portland, OR 97213-2984 | 5032156405 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 5050 Ne Hoyt St, Portland, OR 97213-2984 | PROVIDENCE HEALTH AND SERVICES OREGON | |
| 9205 Sw Barnes Rd, Portland, OR 97225-6603 | 5032161234 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 9205 Sw Barnes Rd, Suite 495, Portland, OR 97225-6603 | 5032161182 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 9205 Sw Barnes Rd Mt, 2800 Prov Med Gr St Vince, Portland, OR 97225-6603 | 5032162621 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 9427 Sw Barnes Rd, Portland, OR 97225-6652 | PROVIDENCE HEALTH AND SERVICES OREGON |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES OREGON |
| Physicians | 1491 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yeong Paul Park | Physical Therapy | Providence Health and Services Oregon | 1627 Woods Ct, Prov Gorg Spi/spo M, Hood River, OR 97031-2915 |
| Traci Ackron | Family Medicine | Providence Health and Services Oregon | 909 Sw 18th Ave, Prov Med Gr Spor Car, Portland, OR 97205-1705 |
| Tierney Newman | Nurse Practitioner | Providence Health and Services Oregon | 4004 Kruse Way Pl, Suite 300, Lake Oswego, OR 97035-2479 |
| Angie R Cronin | Psychologist, Clinical | Providence Health and Services Oregon | 1332 S Shasta Ave, Suite A, Eagle Point, OR 97524-8623 |
| Jennifer N Herr | Nurse Practitioner | Providence Health and Services Oregon | 4805 Ne Glisan, Portland, OR 97213-2933 |
| Jaecelle Guadiz Galeniece | Family Medicine | Providence Health and Services Oregon | 1003 Providence Dr, Suite 325, Newberg, OR 97132-7521 |
| Amelia H Baker | Family Medicine | Providence Health and Services Oregon | 4920 N Interstate Ave, Portland, OR 97217-3653 |
| Sandra Iloka | Family Medicine | Providence Health and Services Oregon | 16770 Sw Edy Rd, 102 Pmg Sherwood Imed Cr, Sherwood, OR 97140-9679 |
| Duy Quang Tran | Family Medicine | Providence Health and Services Oregon | 839 Ne Holladay St, Portland, OR 97232-3521 |
| Steven Vorenkamp | Orthopedic Surgery | Providence Health and Services Oregon | 814 13th St, Hood River, OR 97031-1210 |
| Street Address |
9290 SE SUNNYBROOK BLVD SUITE 120 |
| City | CLACKAMAS |
| State | OR |
| Zip | 97015-6802 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Phoebe Robinson | Physician Assistant | Providence Health and Services Oregon | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 |
| Cindy M Fulton | Physician Assistant | Providence Health and Services Oregon | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 |
| Katie B Mcculloch | Psychologist, Clinical | Providence Health and Services Oregon | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 |
| Heather N Davidson | Physician Assistant | Providence Health and Services Oregon | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 |
| Xiang-hong Song | Hospitalist | Providence Health and Services Oregon | 9290 Se Sunnybrook Blvd, Suite 210, Clackamas, OR 97015-6777 |
| Robyn Elizabeth Nash | Physician Assistant | Providence Health and Services Oregon | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 |
| Benjamin H Ip | Family Medicine | Providence Health and Services Oregon | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 |
| Gregory M Stroup | General Surgery | Providence Health and Services Oregon | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 |
| Navin N Nayak | Internal Medicine | Providence Health and Services Oregon | 9290 Se Sunnybrook Blvd, Suite 210, Clackamas, OR 97015-6777 |
| Cheryl C Pierson | Family Medicine | Providence Health and Services Oregon | 9290 Se Sunnybrook Blvd, Suite 120, Clackamas, OR 97015-6802 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Terrence A Sedgewick | Orthopedic Surgery | Premere Rehab LLC | 11520 Se Sunnyside Rd, Miramont Pointe, Clackamas, OR 97015-4306 |
| Dayna Lynn Bailey | Speech Language Pathologist | Premere Rehab LLC | 11520 Se Sunnyside Rd, Clackamas, OR 97015-4306 |
| Claire M Mysliwy | Physical Therapy | Premere Rehab LLC | 11520 Se Sunnyside Rd, Miramont Pointe, Clackamas, OR 97015-4306 |
| Guadalupe C Gabba | Nurse Practitioner | Kaiser Foundation Health Plan of The Northwest | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5720 |
| Cheryl A Chessick | Psychiatry | Kaiser Foundation Health Plan of The Northwest | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5720 |
| Kathryn N Schwartz | Clinical Social Worker | Kaiser Foundation Health Plan of The Northwest | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5720 |
| Rory E Green | Psychiatry | Kaiser Foundation Health Plan of The Northwest | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5720 |
| Mara M Christensen | Clinical Social Worker | Kaiser Foundation Health Plan of The Northwest | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5720 |
| Seema A Dewani | Psychiatry | Kaiser Foundation Health Plan of The Northwest | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5720 |
| Erin M Wallace | Psychiatry | Kaiser Foundation Health Plan of The Northwest | 10163 Se Sunnyside Rd, Suite 490, Clackamas, OR 97015-5720 |
| Find all physicians in zip 97015 | |||
| City | CLACKAMAS |
| Zip Code | 97015 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | CLACKAMAS + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Paul J Deitering.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.