Provider Demographics
NPI:1275546608
Name:PICCHI, JOANNA CHRISTINA (NP)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:CHRISTINA
Last Name:PICCHI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 LANCASTER DR NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4729
Mailing Address - Country:US
Mailing Address - Phone:503-585-6388
Mailing Address - Fax:503-566-0212
Practice Address - Street 1:304 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FALLS CITY
Practice Address - State:OR
Practice Address - Zip Code:97374
Practice Address - Country:US
Practice Address - Phone:503-787-3353
Practice Address - Fax:503-787-2911
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR80044749363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR291924Medicaid
OR291924Medicaid
OR107268Medicare ID - Type Unspecified
OR291924Medicaid