Provider Demographics
NPI:1407066806
Name:SIMPSON, AMY J (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:J
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:J
Other - Last Name:SAXLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2565 NW LOVEJOY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2996
Mailing Address - Country:US
Mailing Address - Phone:503-226-3376
Mailing Address - Fax:
Practice Address - Street 1:2565 NW LOVEJOY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2996
Practice Address - Country:US
Practice Address - Phone:503-226-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA00777363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant