Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ADDISON DEBOER PA-C
NPI 1679394126
Physician Assistant - Medical in Salem, OR

Q: What is Addison Deboer's NPI number?

The NPI number for Addison Deboer is 1679394126. It was assigned to this individual provider in the NPPES registry on October 17, 2024.

Q: What is Addison Deboer's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Addison Deboer was last updated on July 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 17, 2024PECOS Enrolled

4999 SKYLINE RD S, SALEM, OR 97306(503) 364-4005(503) 364-4006 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 23, 2026, Nov 6, 2024 (2 updates tracked since 2024).

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About Addison Deboer Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADDISON DEBOER PA-C (NPI 1679394126) is an individual medical provider in Salem, Oregon, licensed in Oregon (PA228955) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1679394126

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameADDISON DEBOERCredential: PA-C

Location Address4999 SKYLINE RD SSalem, OR 97306-2878

Mailing AddressPo Box 1517Pendleton, OR 97801-0410 · (877) 708-1119 · Fax (541) 278-8349

Phone(503) 364-4005

Fax(503) 364-4006

Sole ProprietorYes

Medical School CMSOtherGraduated 2025

Enumeration DateOctober 17, 2024

Last NPPES UpdateJuly 23, 20262 updates tracked since enumeration

NPPES CertifiedJuly 23, 2026

✔ NPI 1679394126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in OR · PA228955

4999 SKYLINE RD S, Salem, OR 97306

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Addison Deboer Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4688159395

PECOS Enrollment IDI20260331002566

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CRAIG D ANDERSON MD PC

Anesthesiology (Pain Medicine)

4999 SKYLINE RD S, SUITE 100
SALEM, OR 97306

Marion County (503) 371-4647

DR. HAY MAR SOE M.D.

Internal Medicine (Endocrinology, Diabetes & Metabolism)

4999 SKYLINE RD S
SALEM, OR 97306

Marion County (971) 332-8445

MARY KAY MILLER ANP

Nurse Practitioner (Adult Health)

4999 SKYLINE RD S
SALEM, OR 97306

Marion County (503) 364-4005

MR. DONALD EDWIN WINDER JR. PA

Physician Assistant (Medical)

4999 SKYLINE RD S
SALEM, OR 97306

Marion County (541) 364-4005

GRANT B LONG DPT

Physical Therapist

4999 SKYLINE RD S, SUITE 90
SALEM, OR 97306

Marion County (503) 566-7700

MRS. ASHLEY ANN FORSHEY DPT

Physical Therapist

4999 SKYLINE RD S, SUITE 90
SALEM, OR 97306

Marion County (503) 566-7700

AMY KATHLEEN WHITSA PA-C

Physician Assistant

4999 SKYLINE RD S
SALEM, OR 97306

Marion County (971) 332-8445

DR. PAUL SHOLAR DO

Internal Medicine

4999 SKYLINE RD S
SALEM, OR 97306

Marion County (503) 364-4005

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Addison Deboer's NPI number?

The NPI number for Addison Deboer is 1679394126. It was assigned to this individual provider in the NPPES registry on October 17, 2024.

Where is Addison Deboer located?

Addison Deboer practices at 4999 Skyline Rd S, Salem, OR 97306. The listed phone number is (503) 364-4005.

What is Addison Deboer's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Addison Deboer enrolled in Medicare?

Yes. Addison Deboer is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Addison Deboer was last updated on July 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.