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  • Or Oregon Practitioner Recredentialing App 2012

Get Or Oregon Practitioner Recredentialing App 2012-2025

//www.wpc-edi.com/codes): Additional clinical practice specialties: Gender: Male Type: Female This information may be included in directory listings. Do you want to be designated as a primary care practitioner (PCP)? Yes No Category of professional activity, check all boxes that apply: Clinical practice: Other professional activities: Full time Part time Administration Teaching Locum/temporary Telemedicine Research Retired Other (explain): IV. Other (explain): BOARD CERTIFICAT.

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How to use or fill out the OR Oregon Practitioner Recredentialing App online

Filling out the OR Oregon Practitioner Recredentialing Application is essential for practitioners seeking to maintain their credentials within the state. This guide provides clear, step-by-step instructions for completing the form online while ensuring accuracy and completeness.

Follow the steps to successfully complete your application.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by providing your full legal name, including any suffix or middle name. Ensure that you fill in all sections completely.
  3. Enter your home address and contact information, including telephone numbers and email address. Make sure this information is current.
  4. In the specialty information section, indicate your principal clinical specialty and any additional specialties. This will help in defining your role within healthcare directories.
  5. Complete the board certification section, listing all your current and past certifications. If needed, attach additional sheets for extra information.
  6. Fill in the practice information accurately. This will include details of your primary and secondary practice locations, including contact information.
  7. In the additional education section, include any advanced training or residencies completed within the last three years.
  8. When you reach the attestation questions, respond carefully to each question. Provide any necessary explanations on separate sheets if your answer to any question is 'yes.'
  9. Finally, review the entire form for completeness. Ensure that you have signed and dated the attestation and any necessary sections.
  10. Save your completed application, and if required, print or share the form as directed by the organization you are applying to.

Complete your application online today to ensure your credentials are maintained and recognized.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232