Peck, Amy Samantha

Peck, Amy Samantha is an individual health care provider with primary practice located at 12710 Se Division St , Portland OR 97236-3134. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Primary Care, which is considered as her primary health care specialty. Peck, Amy Samantha can be contacted via phone (503) 988-3601.

Contact Information

Primary practice address
12710 Se Division St Portland OR 97236-3134
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 201907329NP-PP Oregon

Profile Details

NPI number 1174170682
LBN Legal business name Peck, Amy Samantha
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2019
Last updated Aug 20th, 2019 - about 5 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.

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