Healthcare Provider Details

I. General information

NPI: 1235441833
Provider Name (Legal Business Name): PETER FRANCIS VIA PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 HARTMAN LN
SPRINGFIELD OR
97477-1118
US

IV. Provider business mailing address

2400 HARTMAN LN
SPRINGFIELD OR
97477-1118
US

V. Phone/Fax

Practice location:
  • Phone: 541-334-3350
  • Fax:
Mailing address:
  • Phone: 541-334-3350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA222474
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number014022
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA056417
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: