Provider Demographics
NPI:1659485712
Name:ZOTTER, CHRISTINE A (PA-C)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:A
Last Name:ZOTTER
Suffix:
Gender:F
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 1:9035 SW JAMIESON RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1361
Mailing Address - Country:US
Mailing Address - Phone:503-384-0046
Mailing Address - Fax:
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:PORTLAND VETERANS ADMINISTRATION HOSPITAL,P3/OCD
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-1034
Practice Address - Country:US
Practice Address - Phone:503-220-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA00894363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORPA00894OtherPA REGISTRATION NUMBER
ORPA00894OtherPA REGISTRATION NUMBER