Healthcare Provider Details

I. General information

NPI: 1821151309
Provider Name (Legal Business Name): BILLIE LYNN CARTWRIGHT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

685 SE 3RD ST
BEND OR
97702-1754
US

IV. Provider business mailing address

685 SE 3RD ST
BEND OR
97702-1754
US

V. Phone/Fax

Practice location:
  • Phone: 541-686-9070
  • Fax: 541-312-4480
Mailing address:
  • Phone: 541-686-9070
  • Fax: 541-312-4480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number153507
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001000727
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA55546
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 153507
License Number StateOR
# 5
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA60026556
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: