CHRIS ALBERT PETERSEN PAC NPI 1952393241

NPI Information

NPI: 1952393241
Provider Name: CHRIS ALBERT PETERSEN, PAC
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Address:
875 OAK ST SE
SUITE 5020
SALEM, OR
ZIP 97301
Phone: (503) 226-6321
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Chris Albert Petersen, PAC is a surgical physician assistant in Salem, OR. Chris Albert Petersen, PAC NPI is 1952393241. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

875 OAK ST SE
SUITE 5020
SALEM, OR
ZIP 97301-975
Phone: (503) 226-6321
Fax: (503) 227-3422

The enumeration date for this NPI number is 8/22/2005 and was last updated on 8/19/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	PA00211	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	S23087	MEDICARE UPIN	OREGON
2	147747	MEDICARE PIN	OREGON
3	8435877	MEDICAID	WASHINGTON
4	210476	MEDICAID	OREGON
5	116065	MEDICARE ID-TYPE UNSPECIFIED	OREGON	PORTLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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