Individual provider Active NPI

Samantha Ann Stevenson-Stowell, PA-C

  • Physician Assistant
  • Clackamas, OR
National Provider Identifier
1629408794
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA171426 Issued in OR
Practice address
9290 SE Sunnybrook Blvd Ste 120
Clackamas, OR 97015
Phone
(503) 215-2110
NPI assigned
Nov 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA51282 CA
Physician Assistant 363A00000X PA60631240 WA
Physician Assistant 363A00000X PA171426 OR Primary

Addresses

Primary practice location

9290 SE Sunnybrook Blvd Ste 120
Clackamas, OR 97015

Mailing address

9290 SE Sunnybrook Blvd Ste 120
Clackamas, OR 97015-6802
Phone (503) 215-2110

Other practice location 1

16645 SW 134th Ter
Tigard, OR 97224-1834
Phone (503) 883-1785

Other practice location 2

3101 SW Sam Jackson Park Rd
Portland, OR 97239-3009
Phone (503) 241-5090

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sstevensonstowell795750@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150414000397 OR Practitioner - Physician Assistant 9335372804 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
51282CAMDPharmacotherapy Pharmacist
PA51282CAMDPhysician Assistant
PA171426ORMDPhysician Assistant
PA60631240WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Feb 1, 2020 Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 30, 2021 Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Feb 1, 2020 Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

200 S Hazel Dell Way
Canby, OR 97013
Phone (203) 263-9500

9290 SE Sunnybrook Blvd
Ste 210
Clackamas, OR 97015
Phone (503) 216-7960

9290 SE Sunnybrook Blvd
Ste 120
Clackamas, OR 97015
Phone (503) 215-2110

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

5555 NE Elam Young Pkwy
Hillsboro, OR 97124
Phone (503) 216-1600

2400 E Douglas Ave
Bldg K
Newberg, OR 97132
Phone (971) 231-5855

1003 N Providence Dr
Ste 325
Newberg, OR 97132
Phone (503) 216-1661

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

9205 SW Barnes Rd
Portland, OR 97225
Phone (503) 216-1234

9205 SW Barnes Rd
Ste 2800
Portland, OR 97225
Phone (503) 216-2621

1321 NE 99th Ave
Ste 100
Portland, OR 97220
Phone (503) 215-4050

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

5330 NE Glisan St
Ste 100
Portland, OR 97213
Phone (503) 215-9700

10330 SE 32nd Ave
Ste 205
Portland, OR 97222
Phone (503) 513-8950

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

960 N 16th St
Ste 304
Springfield, OR 97477
Phone (541) 744-6172

12442 SW Scholls Ferry Rd
Ste 100
Tigard, OR 97223
Phone (503) 215-9900

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1385424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1629408794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9290 SE SUNNYBROOK BLVD STE 120",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156802",
            "telephone_number": "503-215-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9290 SE SUNNYBROOK BLVD STE 120",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "97015",
            "telephone_number": "503-215-2110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16645 SW 134th Ter",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972241834",
            "country_code": "US",
            "telephone_number": "503-883-1785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3101 SW Sam Jackson Park Rd",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393009",
            "country_code": "US",
            "telephone_number": "503-241-5090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVENSON-STOWELL",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-26",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA51282",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60631240",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA171426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sstevensonstowell795750@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9290 SE Sunnybrook Blvd Ste 120",
            "city": "Clackamas",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.