Individual
CALLIE CHERE' PETERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-4314
(503) 346-6810
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
(866) 617-6855
(503) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA201744
OR
363AS0400X
Surgical Physician Assistant
Primary
PA201744
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500785527
—
OR
Enumeration date
10/13/2020
Last updated
12/10/2024
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