MRS. AMANDA LYNN DICK PEDOTA (NPI# 1831497106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831497106 |
| Entity Type | Individual |
| Full Name | MRS. AMANDA LYNN DICK PEDOTA |
| Other Name | AMANDA LYNN DICK |
| Credential | PA-C |
| Practice Address |
2850 Se Powell Valley Rd Ste 100 Gresham OR 97080-1495 |
| Mailing Address |
14605 Ne Broadway Portland OR 97230-4130 |
| Practice Telephone | 5036665050 |
| Mailing Telephone | (510) 910-4924 |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2017-08-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA183299 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA21501 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2850 SE POWELL VALLEY RD STE 100 |
| City | GRESHAM |
| State | OR |
| Zip Code | 97080-1495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750337432 | Danielle Florence Dalessio | Physician Assistant | 2850 Se Powell Valley Rd Ste 100, Attn: Meg Nau, Gresham, OR 97080-1495 | 2006-05-25 |
| 1760090666 | Nicole Weis | Physician Assistant | 2850 Se Powell Valley Rd Ste 100, Gresham, OR 97080-1495 | 2020-07-16 |
| 1831716646 | Arthur Jeffery Nelson | Physician Assistant | 2850 Se Powell Valley Rd Ste 100, Gresham, OR 97080-1495 | 2020-06-26 |
| 1427550367 | Adam Randall Bartling | Physician Assistant | 2850 Se Powell Valley Rd Ste 100, Gresham, OR 97080-1495 | 2018-03-07 |
| 1598190274 | Kendra M Underhill | Physician Assistant | 2850 Se Powell Valley Rd Ste 100, Gresham, OR 97080 | 2013-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528428554 | Jeffrey Henry Lucero | Social Worker | 4687 Se 1st Terrace, Gresham, OR 97080 | 2016-03-03 |
| 1124371059 | Nickole Turner | Massage Therapist | 2831 Se Palmquist Rd #157, Gresham, OR 97080 | 2012-10-16 |
| 1992061048 | Russell A Wendt | Pharmacist | 2497 Ne Roberts Ave, Gresham, OR 97080 | 2012-04-03 |
| 1821385584 | Angela West | Counselor | 320 Sw 6th Ave., Gresham, OR 97080 | 2011-07-01 |
| 1043543572 | Natalie Dawn Wilson | Behavioral Analyst | 97 Sw Riverview Place, Gresham, OR 97080 | 2009-09-16 |
| 1427205442 | Maria G Jolley | Dental Hygienist | 1267 Se Stapleton Loop, Gresham, OR 97080 | 2008-08-21 |
| 1073776738 | Sabrina Joye Hindman | Marriage & Family Therapist | 6370 Se 26th St, Gresham, OR 97080 | 2008-07-03 |
| 1669676193 | Kimberly Sabin | Nurse Practitioner | 2222 E Powell Blvd, Gresham, OR 97080 | 2007-06-11 |
| 1932223880 | Julie Elizabeth Croshaw | Pharmacist | 2444 E Powell Blvd, Gresham, OR 97080 | 2007-03-18 |
| 1508903261 | Lonetta Elise Davis | Adult Companion | 349 Se Plamblad, Gresham, OR 97080 | 2007-01-31 |
| Find all providers in zip 97080 | ||||
| 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 |
|---|---|---|---|---|
| 1285957407 | Muthoni Kihiko Ehmann | Physician Assistant | 831 Nw Council Suite 300, Gresham, OR 97030 | 2010-03-02 |
| 1750337432 | Danielle Florence Dalessio | Physician Assistant | 2850 Se Powell Valley Rd Ste 100, Attn: Meg Nau, Gresham, OR 97080-1495 | 2006-05-25 |
| 1760090666 | Nicole Weis | Physician Assistant | 2850 Se Powell Valley Rd Ste 100, Gresham, OR 97080-1495 | 2020-07-16 |
| 1831716646 | Arthur Jeffery Nelson | Physician Assistant | 2850 Se Powell Valley Rd Ste 100, Gresham, OR 97080-1495 | 2020-06-26 |
| 1265080006 | Katherine Geller | Physician Assistant | 831 Nw Council Drive, Gresham, OR 97030-3723 | 2019-08-26 |
| 1215582861 | Joshua Gardner Snow | Physician Assistant | 2850 Se Powell Valley Rd, Gresham, OR 97080-1494 | 2019-08-08 |
| 1255802849 | Sandra S Hwang | Physician Assistant | 24988 Se Stark St Ste 220, Gresham, OR 97030-8324 | 2018-12-08 |
| 1134609043 | Jennifer Stephens | Physician Assistant | 2850 Se Powell Valley Rd, Gresham, OR 97080-1494 | 2018-08-20 |
| 1427550367 | Adam Randall Bartling | Physician Assistant | 2850 Se Powell Valley Rd Ste 100, Gresham, OR 97080-1495 | 2018-03-07 |
| 1427584077 | Margeaux Danielle Schmerler | Physician Assistant | 2850 Se Powell Valley Rd, Gresham, OR 97080 | 2017-05-02 |
| Find all providers in GRESHAM | ||||
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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.