MEDICARE: SIERRA HOPE ZEVENBERGEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		NY

General Provider Information

NPI Number	:	1669334447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA HOPE ZEVENBERGEN

Provider Business Mailing Address
First Line	:	16860 LAKERIDGE DR
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97034-6819
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E 77TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10075-1850
Country	:	US
Telephone Number	:	212-434-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2025
Last Update Date	:	12/01/2025

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Directions to “ SIERRA HOPE ZEVENBERGEN ” Practice Location

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