Healthcare Provider Details

I. General information

NPI: 1104170489
Provider Name (Legal Business Name): CHLOE KAY NORRIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2012
Last Update Date: 02/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 SW PERKINS AVE
PENDLETON OR
97801-4302
US

IV. Provider business mailing address

2450 SW PERKINS AVE
PENDLETON OR
97801-4302
US

V. Phone/Fax

Practice location:
  • Phone: 541-276-1700
  • Fax: 541-276-6327
Mailing address:
  • Phone: 541-276-1700
  • Fax: 541-276-6327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA 60316612
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA176507
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: