Individual provider · Type 1 NPI

Amy Samantha Peck

Primary Care Nurse Practitioner · Portland, OR

NPI number 1174170682 Active

Practice location

12710 SE Division St
Portland, OR 97236-3134

Mailing address

4222 NE Cleveland Ave
Portland, OR 97211-2704

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300X201907329NP-PP (OR)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1174170682

Amy Samantha Peck's National Provider Identifier is 1174170682, issued on Aug 20, 2019. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Portland, OR. The record was last updated on Aug 20, 2019.