Provider Demographics
NPI:1790905164
Name:ADKINS, SAMANTHA RAE (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:RAE
Last Name:ADKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6564 SE LAKE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-2237
Mailing Address - Country:US
Mailing Address - Phone:503-908-5880
Mailing Address - Fax:888-475-8729
Practice Address - Street 1:6564 SE LAKE RD STE 200
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-2237
Practice Address - Country:US
Practice Address - Phone:503-908-5880
Practice Address - Fax:888-475-8729
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27393207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR272399Medicaid