Pamela A. Devisser, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

88-006444 Issued in OR

Practice address

18040 SW Lower Boones Ferry Rd
Suite 100
Tigard, OR 97224-7258

Phone

(503) 216-0700

Fax

(503) 216-0750

NPI assigned

Nov 29, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Northwest Primary Care Group, PC

  • Family Medicine Physician
  • Milwaukie, OR
  • NPI 1558572180
  NPD (past)

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1952384430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "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": "18040 SW LOWER BOONES FERRY RD",
            "address_2": "SUITE 100",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247258",
            "telephone_number": "503-216-0700",
            "fax_number": "503-216-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVISSER",
        "first_name": "PAMELA",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-29",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "88-006444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00777838",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056994",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Jeanne Depenna
• Dermatology Associates,P.C.
• Neil J Desouza, M.D.
• Patricia Lynn Desrochers, LCSW
• Nancy Devine, MS, CCC-SLP
• Alexandra Rose Devivo
• Lane Dewan, PSY.D.
• Vanessa Brizuela Dewees
• David Anthony Dewitt
• Sarah Jeanne Dexheimer

• Family Nurse Practitioner in Tigard, OR
• Providers in Tigard, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.