AMANDA MARIE SMITH (NPI# 1669574943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669574943 |
| Entity Type | Individual |
| Full Name | AMANDA MARIE SMITH |
| Other Name | AMANDA MARIE CLARK |
| Credential | PA-C |
| Practice Address |
9900 Se Sunnyside Rd Sunnybrook Medical Office Clackamas OR 97015-9777 |
| Mailing Address |
5913 N Commercial Ave Portland OR 97217-2014 |
| Practice Telephone | 5037868435 |
| Mailing Telephone | 3604613933 |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2007-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | OR PA01036 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508467010 | Amanda Dawn Smith | Physician Assistant | 1621 Spruce St, Zanesville, OH 43701-2534 | 2020-11-03 |
| 1689281297 | Amanda Joy Smith | Massage Therapist | 4915 Rue Vallee Apt 89, Indianapolis, IN 46227-6660 | 2020-09-28 |
| 1902422033 | Amanda Elaine Smith | Nurse Practitioner | 116 Tracy Miles Rd, Franklin, IN 46131-5547 | 2020-06-24 |
| 1619500519 | Amanda Leigh Smith | Marriage & Family Therapist | 1012 Greta St, El Cajon, CA 92021-3258 | 2020-02-19 |
| 1245861335 | Amanda Monique Leanne Smith | Massage Therapist | 4400 Bayou Blvd Ste 26b, Pensacola, FL 32503-1908 | 2020-01-28 |
| 1811544414 | Amanda Rae Smith | Behavior Technician | 105 Clubhouse Cir Apt 102, Idaho Falls, ID 83401-4328 | 2019-08-20 |
| 1306400072 | Amanda J Smith | Occupational Therapy Assistant | 8811 Sandy Plains Dr, Riverview, FL 33578-8619 | 2019-04-27 |
| 1861056079 | Amanda Lynn Smith | Nurse Practitioner | 3785 E Stampede Dr, Gilbert, AZ 85297-8203 | 2019-04-24 |
| 1164996864 | Amanda Marie Smith | Student in an Organized Health Care Education/Training Program | 527 12th Ave E Apt 203, Seattle, WA 98102-5114 | 2019-01-15 |
| 1245701796 | Amanda Michelle Smith | Dietitian, Registered | 20 Columbia Pl Apt B045, Brooklyn, NY 11201-4591 | 2018-12-10 |
| Street Address |
9900 SE SUNNYSIDE RD SUNNYBROOK MEDICAL OFFICE |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-9777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982675690 | Tony S Clinton | Dermatology | 9900 Se Sunnyside Rd, Kaiser Permanente Sunnybrook Medical Office, Clackamas, OR 97015-9777 | 2006-01-30 |
| 1700395811 | Jeffrey Ha Nguyen | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2017-09-21 |
| 1255850434 | Taylor Martin | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2017-09-19 |
| 1386189595 | Darin Ferry | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-12-23 |
| 1720530058 | Kaiser Foundation Health Plan of The Northwest | General Practice | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-11-03 |
| 1912458944 | Kimberly Brownell | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-10-14 |
| 1487104956 | Sze Wing Ngan | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-10-10 |
| 1740738327 | Frederick R Engelmann | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-09-13 |
| 1215483680 | Clifford Stephens | Pharmacist | 9900 Se Sunnyside Rd, Clackamas, OR 97015-9777 | 2016-08-26 |
| 1235594896 | Celeste Richardson | Physician Assistant | 9900 Se Sunnyside Rd, Kaiser Permanente Sunnybrook Medical Office, Clackamas, OR 97015-9777 | 2015-12-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558645812 | Jenna Smith | Physician Assistant | 9290 Se Sunnybrook Blvd Ste 120, Clackamas, OR 97015-6802 | 2011-10-05 |
| 1821183229 | Frank John Pacosa | Physician Assistant | 9800 Sunnyside Rd., Clackamas, OR 97015 | 2006-10-03 |
| 1306930722 | Todd Joseph Van Hee | Physician Assistant | Kaiser Permanente Mt Scott Medical Office, 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2006-10-02 |
| 1710943402 | Billy L. Cunnington | Physician Assistant | 10330 Se 32nd Avenue, Suite 210, Clackamas, OR 97222-6594 | 2006-04-22 |
| 1225686611 | Brittney Nichole Nelson | Physician Assistant | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2019-08-28 |
| 1831674985 | German Collazo | Physician Assistant | 10180 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2018-09-25 |
| 1437671617 | Amber Marie Morrison | Physician Assistant | 9800 Se Sunnyside Rd, Clackamas, OR 97015-9750 | 2017-07-10 |
| 1922451103 | Mackenna Marie Simpson | Physician Assistant | 9290 Se Sunnybrook Blvd, #120, Clackamas, OR 97015-6899 | 2016-07-22 |
| 1235594896 | Celeste Richardson | Physician Assistant | 9900 Se Sunnyside Rd, Kaiser Permanente Sunnybrook Medical Office, Clackamas, OR 97015-9777 | 2015-12-28 |
| 1629408794 | Samantha Ann Stevenson-stowell | Physician Assistant | 9290 Se Sunnybrook Blvd Ste 120, Clackamas, OR 97015 | 2013-11-26 |
| Find all providers in CLACKAMAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.