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General NPI Number Information
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NPI Number | 1083091029
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Entity Type | Individual
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Provider Name | PAIGE PATTILLO NP
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Gender | Female
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Dates
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Enumeration Date | 04/29/2015
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Last Update Date | 12/27/2025
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Provider Practice Location Address
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Address Line | 41805 STAYTON SCIO RD SE
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City | STAYTON
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State | OR
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Zip | 97383-9739
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Country | US
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Telephone | 503-507-5356
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Fax | 866-225-2708
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Provider Business Mailing Address
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Address Line | PO BOX 118
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City | STAYTON
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State | OR
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Zip | 97383-0118
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Country | US
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Telephone | 503-507-5356
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Fax | 866-225-2708
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 201601264NP-PP
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-054204
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 201601264NP-PP
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1-054204
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License Number State | AL
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