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Contact Information

PAUL J DEITERING, PA-C
9427 SW BARNES RD
SUITE 490
PORTLAND, OR97225-6652
 Phone: 503-291-2123
 Fax: 503-292-1860
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Clinical Cardiac Electrophysiology

207RC0001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PAUL J DEITERING · (Male)

NPI # 1598701690
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 06/20/2006
Last updated 03/09/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • OR License # PA00711
  • OR Medicaid 286755
Hospital affiliation(s)
  • PROVIDENCE HOOD RIVER MEMORIAL HOSPITAL - (Critical Access)
    810 12TH STREET
    HOOD RIVER, OR 97031
  • PROVIDENCE NEWBERG MEDICAL CENTER - (Acute Care)
    1001 PROVIDENCE DRIVE
    NEWBERG, OR 97132
  • PROVIDENCE PORTLAND MEDICAL CENTER - (Acute Care)
    4805 NE GLISAN STREET
    PORTLAND, OR 97213
  • PROVIDENCE SEASIDE HOSPITAL - (Critical Access)
    725 S WAHANNA ROAD
    SEASIDE, OR 97138
  • PROVIDENCE ST VINCENT MEDICAL CENTER - (Acute Care)
    9205 SW BARNES ROAD
    PORTLAND, OR 97225
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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