Black, Amy C
Black, Amy C is an individual health care provider with primary practice located at 1510 Division St Suite 200, Oregon City OR 97045-1581. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Black, Amy C can be contacted via phone (503) 650-6880.Contact Information
Primary practice address
1510 Division St Suite 200
Oregon City OR 97045-1581
Phone: (503) 650-6880
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1031913 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA163381 | Oregon |
Profile Details
| NPI number | 1871791699 |
|---|---|
| LBN Legal business name | Black, Amy C |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2007 |
| Last updated | Jan 13th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871791699 | NPPES |
| Oregon | MEDICAID | 500663461 |
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