Jaclyn Renee Derosso (NPI# 1184186447, PAC ID# 2668700964) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is QUALIFIED AUDIOLOGIST.
| Nation Provider ID (NPI) | 1184186447 |
| PAC ID by PECOS | 2668700964 |
| Professional Enrollment ID | I20190823003504 |
| Full Name | Jaclyn Renee Derosso |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES OREGON |
| Address |
310 Villa Rd Suite 101 Newberg OR 97132-1886 |
| Phone Number | 5035373546 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | QUALIFIED AUDIOLOGIST |
| Group Practice PAC ID | 0648183608 |
| Number of Group Practice Members | 1163 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1003 Providence Dr, Suite 325, Newberg, OR 97132-7521 | 5032161661 | PROVIDENCE HEALTH AND SERVICES OREGON |
| 310 Villa Rd, Suite 101, Newberg, OR 97132-1886 | 5035373546 | 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 |
310 VILLA RD SUITE 101 |
| City | NEWBERG |
| State | OR |
| Zip | 97132-1886 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yaping Wu | Pathology | Providence Health and Services Oregon | 310 Villa Rd, Suite 106, Newberg, OR 97132-1886 |
| Rachel E Furman | Qualified Speech Language Pathologist | Providence Health and Services Oregon | 310 Villa Rd, Suite 101, Newberg, OR 97132-1886 |
| Deanna J Olson | Qualified Audiologist | Providence Health and Services Oregon | 310 Villa Rd, Suite 101, Newberg, OR 97132-1886 |
| Casandra Nicole Glatz | Qualified Speech Language Pathologist | Providence Health and Services Oregon | 310 Villa Rd, Suite 101, Newberg, OR 97132-1886 |
| Shaozeng Zhang | Pathology | Providence Health and Services Oregon | 310 Villa Rd, Suite 106, Newberg, OR 97132-1886 |
| Veselina Borisova Korcheva | Pathology | Providence Health and Services Oregon | 310 Villa Rd, Suite 106, Newberg, OR 97132-1886 |
| Kyla J Laraway | Occupational Therapy | Providence Health and Services Oregon | 310 Villa Rd, Suite 101, Newberg, OR 97132-1886 |
| Sanaa Hussain | Pathology | Providence Health and Services Oregon | 310 Villa Rd, Suite 106, Newberg, OR 97132-1886 |
| Sarah Grace Fitch | Qualified Audiologist | Providence Health and Services Oregon | 310 Villa Rd, Suite 101, Newberg, OR 97132-1886 |
| Leanne S Klein | Occupational Therapy | Providence Health and Services Oregon | 310 Villa Rd, Suite 101, Newberg, OR 97132-1886 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sheila M Smith | Nurse Practitioner | 1819 Haworth Ave, Newberg, OR 97132-1211 | |
| Jeremy W Taylor | Optometry | Newberg Vision Clinic, P.C. | 2207 Portland Rd, A, Newberg, OR 97132-1371 |
| Paula A Taylor | Optometry | Newberg Vision Clinic, P.C. | 2207 Portland Rd, A, Newberg, OR 97132-1371 |
| Zoey Eleni Stoumbos | Ophthalmology | Oregon Eye Specialists, PC | 2318 Portland Rd, Suite 300, Newberg, OR 97132-1374 |
| May Khadem | Ophthalmology | Oregon Eye Specialists, PC | 2318 Portland Rd, Suite 300, Newberg, OR 97132-1374 |
| Anna Marie Q Macasa | Rheumatology | 402 Villa Rd, Newberg, OR 97132-1831 | |
| Randy L Sasich | Pulmonary Disease | Providence Health and Services - Oregon | 501 Villa Rd, Newberg, OR 97132-1832 |
| Robert J Weniger | Psychologist, Clinical | 515 N Villa Rd, Newberg, OR 97132-1832 | |
| John Alan Butler | Pulmonary Disease | Providence Health and Services - Oregon | 501 Villa Rd, Newberg, OR 97132-1832 |
| Jo Carolyn Hernandez | Pathology | Providence Health and Services - Oregon | 501 Villa Rd, Newberg, OR 97132-1832 |
| Find all physicians in zip 97132 | |||
| City | NEWBERG |
| Zip Code | 97132 |
| Specialty | QUALIFIED AUDIOLOGIST |
| City + Specialty | NEWBERG + QUALIFIED AUDIOLOGIST |
Please comment or provide details below to improve the information on Jaclyn Renee Derosso.
| 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.