Individual provider Active NPI

Camille Sabrina Snyder, PA-C

  • Medical Physician Assistant
  • Portland, OR
National Provider Identifier
1821175043
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA00972 Issued in OR
Practice address
1321 NE 99TH Ave
Suite 100
Portland, OR 97220-9436
Phone
(503) 215-9900
Fax
(503) 215-4055
NPI assigned
Nov 1, 2006
Last updated
Oct 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA00972 OR Primary

Addresses

Primary practice location

1321 NE 99TH Ave
Suite 100
Portland, OR 97220-9436

Mailing address

PO Box 3158
Attn: Credentialing
Portland, OR 97208-3158
Phone (503) 215-6494

Other identifiers 1

IdentifierTypeStateIssuer
500604474MedicaidOR

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address csnyder107717@oc.providencedirect.org
Direct Messaging Address csnyder107717@oc.providencedirect.org
Direct Messaging Address csnyder107717@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
I20040818000653 OR Practitioner - Physician Assistant 6406829381 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12345 SW Horizon Blvd
Suite 57
Beaverton, OR 97007-9475
Phone (503) 216-8820

1321 NE 99TH Ave
Suite 200
Portland, OR 97220-9439
Phone (503) 215-4250

4400 NE Halsey St
Portland, OR 97213-1545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA00972ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 8, 2008 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 8, 2008 Accepting new patients
Providence Health & Services - Oregon CurrentSince Aug 1, 2013 Accepting new patients
Providence Health & Services Oregon CurrentSince Aug 1, 2013 Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients
Providence Health & Services - Oregon Past Accepting new patients

Locations

12345 SW Horizon Blvd
Ste 57
Beaverton, OR 97007
Phone (503) 216-8820

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

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

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

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

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

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

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

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

15640 NW Laidlaw Rd
Ste 102
Portland, OR 97229
Phone (503) 764-0100

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

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

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

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

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

Interoperability endpoints

  • Direct secure messaging: csnyder107717@oc.providencedirect.org

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1821175043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494",
            "fax_number": "503-215-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 NE 99TH AVE",
            "address_2": "SUITE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972209436",
            "telephone_number": "503-215-9900",
            "fax_number": "503-215-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNYDER",
        "first_name": "CAMILLE",
        "middle_name": "SABRINA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA00972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500604474",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csnyder107717@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "12345 SW Horizon Blvd Ste 57",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970079475",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csnyder107717@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1321 NE 99th Ave Ste 200",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972209439",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csnyder107717@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "9205 SW Barnes Rd",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972256603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.