Peter Michael Dejong, MD | |
16770 Sw Edy Rd Ste 102, Sherwood, OR 97140-9679 | |
(503) 216-9600 | |
Not Available |
Full Name | Peter Michael Dejong |
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Gender | Male |
Speciality | Family Medicine |
Location | 16770 Sw Edy Rd Ste 102, Sherwood, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750887493 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2083S0010X | Preventive Medicine - Sports Medicine | MD212000 (Oregon) | Secondary |
207Q00000X | Family Medicine | MD212000 (Oregon) | Primary |
Entity Name | Providence Health & Services Oregon |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023488343 PECOS PAC ID: 0648183608 Enrollment ID: O20031106000652 |
Mailing Address | Practice Location Address |
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Peter Michael Dejong, MD Po Box 3158, Portland, OR 97208-3158 Ph: (503) 215-6494 | Peter Michael Dejong, MD 16770 Sw Edy Rd Ste 102, Sherwood, OR 97140-9679 Ph: (503) 216-9600 |
Cheryl Catherine Pierson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16770 Sw Edy Rd, Suite 102, Sherwood, OR 97140 Phone: 503-216-9600 | |
Dr. Patricia Eden Fernandez Millan, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16770 Sw Edy Rd, Suite 102, Sherwood, OR 97140 Phone: 503-216-9600 | |
Amy L Gerhard, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16770 Sw Edy Rd, Sherwood, OR 97140 Phone: 503-216-9600 Fax: 503-216-9650 | |
Lindsay Megan Sparks, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16770 Sw Edy Rd Ste 102, Sherwood, OR 97140 Phone: 503-216-9600 | |
Andrew D Glass, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16770 Sw Edy Rd, Suite 102, Sherwood, OR 97140 Phone: 503-215-9600 | |
Raymond F Higby, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 16770 Sw Edy Rd, Sherwood, OR 97140 Phone: 503-216-9600 Fax: 503-216-9650 | |
Derrick Evan Hall, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 16770 Sw Edy Rd Ste 102, Sherwood, OR 97140 Phone: 503-216-9600 |