STEPHANIE LOCICERO

PORTLAND, OR
NPI1659937456
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: OR  PA213429)
Additional Taxonomies207R00000X Internal Medicine
(Licence: NY  23973)
363A00000X Physician Assistant
Enumeration Date2019-05-16
Last Update Date2023-07-17
Business Address
STEPHANIE LOCICERO PA-C
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 503-494-6594
Mailing Address
STEPHANIE LOCICERO PA-C
1400 SW 5TH AVE STE 500
PORTLAND, OR 97201-5537
Phone number: 866-617-6855