Individual provider · Type 1 NPI

Stephanie Locicero, PA-C

Medical Physician Assistant · Portland, OR

NPI number 1659937456 Active

Practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011

Call (503) 494-6594 Map

Fax (503) 494-4285

Mailing address

1400 SW 5th Ave Ste 500
Portland, OR 97201-5537

Other practice locations

  • 601 Elmwood Ave, Rochester, NY 14642-1603 · (585) 275-0526

Specialties and licenses

TaxonomyCodeLicense
Internal Medicine Physician 207R00000X23973 (NY)
Physician Assistant 363A00000XNone listed
Medical Physician Assistant Primary 363AM0700XPA213429 (OR)

Medical Physician Assistant: Definition to come...

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About NPI 1659937456

Stephanie Locicero, PA-C's National Provider Identifier is 1659937456, issued on May 16, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Portland, OR. The record was last updated on Jul 17, 2023.