Jessica Ann Pettitt (NPI# 1801344601, PAC ID# 3274814330) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1801344601 |
| PAC ID by PECOS | 3274814330 |
| Professional Enrollment ID | I20170103001262 |
| Full Name | Jessica Ann Pettitt |
| Organization Legal Name | PACIFIC KIDNEY AND HYPERTENSION LLC |
| Address |
24900 Se Stark St Suite 109 Gresham OR 97030-3381 |
| Phone Number | 5032841937 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 1759513468 |
| Number of Group Practice Members | 18 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380061 | PROVIDENCE PORTLAND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 24900 Se Stark St, Suite 109, Gresham, OR 97030-3381 | 5032841937 | PACIFIC KIDNEY AND HYPERTENSION LLC |
| 1547 Ne 40th Ave, Portland, OR 97232-1862 | 5032841937 | PACIFIC KIDNEY AND HYPERTENSION LLC |
| 1547 Ne 40th Ave, Suite B, Portland, OR 97232-1862 | 5032841937 | PACIFIC KIDNEY AND HYPERTENSION LLC |
| 9155 Sw Barnes Rd, Portland, OR 97225-6630 | PACIFIC KIDNEY AND HYPERTENSION LLC |
| Organization Legal Name | PACIFIC KIDNEY AND HYPERTENSION LLC |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sushil S Deshmukh | Nephrology | Pacific Kidney and Hypertension LLC | 1547 Ne 40th Ave, Portland, OR 97232-1862 |
| Geoffrey Xiao | Physician Assistant | Pacific Kidney and Hypertension LLC | 15895 Sw 72nd Ave, Suite 250, Tigard, OR 97224-7966 |
| Firas George Khoury | Nephrology | Pacific Kidney and Hypertension LLC | 220 Ne Norton Ln, Mcminnville, OR 97128-8470 |
| Supriya Khan | Nephrology | Pacific Kidney and Hypertension LLC | 220 Ne Norton Ln, Mcminnville, OR 97128-8470 |
| Sonia Valeria Bynum | Nephrology | Pacific Kidney and Hypertension LLC | 24900 Se Stark St, Suite 109, Gresham, OR 97030-3381 |
| Shweta S Patel | Nephrology | Pacific Kidney and Hypertension LLC | 220 Ne Norton Ln, Mcminnville, OR 97128-8470 |
| Hongshi Xu | Nephrology | Pacific Kidney and Hypertension LLC | 315 Se Stonemill Dr, Suite 220, Vancouver, WA 98684-6987 |
| Katrina G Carli | Nephrology | Pacific Kidney and Hypertension LLC | 3901 Hoyt Ave, Everett, WA 98201-4918 |
| Sallie Israelit | Nephrology | Pacific Kidney and Hypertension LLC | 10330 Se 32nd Ave, Suite 210, Milwaukie, OR 97222-6594 |
| Robin E Fowler Lee | Nurse Practitioner | Pacific Kidney and Hypertension LLC | 3901 Hoyt Ave, Everett, WA 98201-4918 |
| Street Address |
24900 SE STARK ST SUITE 109 |
| City | GRESHAM |
| State | OR |
| Zip | 97030-3381 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael C Barth | Physician Assistant | Mtn View Family Practice, PC | 24900 Se Stark St, Suite 205, Gresham, OR 97030-3382 |
| Richard S Polin | Neurosurgery | Richard S Polin PC | 24900 Se Stark St, Suite 208, Gresham, OR 97030-3382 |
| Richard W Craft | Internal Medicine | Cascade Physicians PC | 24900 Se Stark St, Suite 202, Gresham, OR 97030-3382 |
| Sonia Valeria Bynum | Nephrology | Pacific Kidney and Hypertension LLC | 24900 Se Stark St, Suite 109, Gresham, OR 97030-3381 |
| Paul V Podett | Emergency Medicine | Mtn View Family Practice, PC | 24900 Se Stark St, Suite 205, Gresham, OR 97030-3382 |
| Jaspreet Kaur Khangura | Internal Medicine | Legacy Mount Hood Medical Center | 24900 Se Stark St, 109 Legacy Clinic Gresham Internal Medicine, Gresham, OR 97030-3381 |
| Brooke B Lowry | Physician Assistant | Mtn View Family Practice, PC | 24900 Se Stark St, Suite 205, Gresham, OR 97030-3382 |
| Paul D Ruesch | Orthopedic Surgery | 24900 Se Stark St, Suite 208, Gresham, OR 97030-3382 | |
| Kenneth E Lee | Physician Assistant | Richard S Polin PC | 24900 Se Stark St, Suite 208, Gresham, OR 97030-3382 |
| Bret T Kean | Orthopedic Surgery | Bret T Kean Md PC | 24900 Se Stark St, Suite 208, Gresham, OR 97030-3382 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Anne T Daly | Nurse Practitioner | Multnomah County | 2020 Se 182nd Ave, Rockwood Health Center, Gresham, OR 97030 |
| David A Pierce | Family Medicine | Multnomah County | 2020 Se 182nd Ave, Rockwood Health Center, Gresham, OR 97030 |
| Agnes White | Nurse Practitioner | Multnomah County | 2020 Se 182nd Ave, Rockwood Health Center, Gresham, OR 97030 |
| Jaclyn Jones | Nurse Practitioner | Multnomah County | 2020 Se 182nd Ave, Rockwood Health Center, Gresham, OR 97030 |
| Elizabeth Claire Yiu | Nurse Practitioner | Multnomah County | 2020 Se 182nd Ave, Rockwood Health Center, Gresham, OR 97030 |
| Emma Moore | Nurse Practitioner | Multnomah County | 2020 Se 182nd Ave, Rockwood Health Center, Gresham, OR 97030 |
| Mary Jepson | Nurse Practitioner | Multnomah County | 2020 Se 182nd Ave, Rockwood Health Center, Gresham, OR 97030 |
| Amanda Cort | Nurse Practitioner | Multnomah County | 2020 Se 182nd Ave, Rockwood Health Center, Gresham, OR 97030 |
| John L Strauss | Chiropractic | 620 Se 223rd Ave, Gresham, OR 97030-2510 | |
| Mark A George | Optometry | 22640 Se Stark St, Gresham, OR 97030-2684 | |
| Find all physicians in zip 97030 | |||
| City | GRESHAM |
| Zip Code | 97030 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | GRESHAM + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Jessica Ann Pettitt.
| 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.