Rothacker Peyton, Sally

Rothacker Peyton, Sally is an individual health care provider with primary practice located at 619 Nw 6Th Ave Fl 3 , Portland OR 97209-3964. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Rothacker Peyton, Sally can be contacted via phone (503) 988-3663.

Contact Information

Primary practice address
619 Nw 6Th Ave Fl 3 Portland OR 97209-3964
Phone: (503) 988-3663
Fax: (503) 988-4098
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X R042060 Maine

Profile Details

NPI number 1952386732
LBN Legal business name Rothacker Peyton, Sally
Credentials APRNCS, PMH-NP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2005
Last updated Nov 26th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1952386732 NPPES
Maine MEDICAID 123350000

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