Individual provider Active NPI

Lori Farmer, PA-C

  • Physician Assistant
  • Hermiston, OR
National Provider Identifier
1932504115
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA216285 Issued in OR
Practice address
1623 N 1St St
Hermiston, OR 97838-1106
Phone
(458) 300-9014
Fax
(458) 300-9015
NPI assigned
Oct 29, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 60511314 WA
Physician Assistant 363A00000X PA216285 OR Primary

Addresses

Primary practice location

1623 N 1St St
Hermiston, OR 97838-1106

Mailing address

62115 Meadow Way E
Enumclaw, WA 98022-8074
Phone (253) 569-8079

Other practice location 1

1716 W Marine View Dr Ste C
Everett, WA 98201-2098
Phone (425) 259-0212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150129000588 WA Practitioner - Physician Assistant 2668795865 Reassigns benefits to 4 organizations
I20230803001323 OR Practitioner - Physician Assistant 2668795865 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60511314WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC CurrentSince Jul 7, 2023 Accepting new patients

Locations

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611

1623 N 1st St
Hermiston, OR 97838
Phone (458) 300-9014

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

Organizations & group practices 5

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": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1932504115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62115 MEADOW WAY E",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980228074",
            "telephone_number": "253-569-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 N 1ST ST",
            "city": "HERMISTON",
            "state": "OR",
            "postal_code": "978381106",
            "telephone_number": "458-300-9014",
            "fax_number": "458-300-9015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1716 W Marine View Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982012098",
            "country_code": "US",
            "telephone_number": "425-259-0212",
            "fax_number": "425-259-0209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARMER",
        "first_name": "LORI",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "60511314",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA216285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermiston, OR

Sources for this page

Verify at the official NPI Registry.