Provider Demographics
NPI:1033123450
Name:CROZIER, DENNIS (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:
Last Name:CROZIER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11790 SW BARNES RD STE 330
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5935
Mailing Address - Country:US
Mailing Address - Phone:503-228-4414
Mailing Address - Fax:503-228-7293
Practice Address - Street 1:2120 EXCHANGE ST STE 302
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-3364
Practice Address - Country:US
Practice Address - Phone:971-310-1000
Practice Address - Fax:100-000-0000
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA01098363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical