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Stacey Ann Wheeler

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

PECOS Enrollment

This provider is enrolled in PECOS as STACEY WHEELER.

Based on the most recent information from CMS, provider Stacey Ann Wheeler is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1679815302
Provider Type
Individual
Full Name
Wheeler, Stacey Ann
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
3/20/2013
Last Updated
5/17/2023

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 418-0990

(503) 494-4982

Mailing Location

3181 SW Sam Jackson Park Rd, Portland, OR 97239-3011

(503) 418-0990

(503) 494-4982

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA175460 Oregon
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Stacey Ann Wheeler

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Myers, Jeffrey

Barclift, Hannah

Spencer, Mary Ellen

Friberg, Whitni Nicole

Kading, Laura

Peoro, Kimberly

Atwood, Ashley

Ordway, Emma Claire

Ahmad, Zoha

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