Maci Pfaffenberger, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA180305 Issued in OR

Practice address

2850 SE Powell Valley Rd
Gresham, OR 97080

Phone

(503) 666-5050

Fax

(503) 666-1162

NPI assigned

Jul 19, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Columbia Anesthesia Group P S

  • Anesthesiology Physician
  • Vancouver, WA
  • NPI 1861448235
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1225481906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 SE POWELL VALLEY RD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "97080",
            "telephone_number": "503-666-5050",
            "fax_number": "503-666-1162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Coburg Rd",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974014995",
            "country_code": "US",
            "telephone_number": "541-345-8760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25045 Dunham Rd",
            "address_purpose": "LOCATION",
            "city": "Veneta",
            "state": "OR",
            "postal_code": "97487",
            "country_code": "US",
            "telephone_number": "541-935-2035",
            "fax_number": "541-935-6608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 Coburg Rd",
            "address_purpose": "LOCATION",
            "city": "Eugene",
            "state": "OR",
            "postal_code": "974014995",
            "country_code": "US",
            "telephone_number": "541-345-8760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PFAFFENBERGER",
        "first_name": "MACI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA180305",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA180305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jensine Peterson, LCSW
• Pamela Diane Peterson, LMT
• Aaron Petrarca
• David Pettit
• Erin Petty
• Barbara Allen Pfeiffer, LMT
• Paige Pfunder, D.O.
• Vivian Lan Anh Pham, PHARMD
• Chelsea A Phelan, PSS/QMHP-C
• Amber Phillips

• Medical Physician Assistant in Gresham, OR
• Providers in Gresham, OR by specialty
• Medical Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.