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Oregon Practitioner Credentialing Application Addendum. Identifying Information Applicant Last Name: First: Middle: Medical Group/IPA Affiliation(s): II. PRACTICE REMIT (BILLING) INFORMATION Name
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What is Oregon Practitioner Credentialing Application Addendum Form?

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The Oregon practitioner credentialing application is a form that healthcare professionals must complete in order to be credentialed to provide services in the state of Oregon.
Healthcare professionals such as doctors, nurses, and other practitioners who wish to practice in Oregon are required to file the practitioner credentialing application.
The practitioner credentialing application can be filled out online on the Oregon Health Authority website or by mail. Applicants must provide information about their education, training, work experience, and references.
The purpose of the Oregon practitioner credentialing application is to ensure that healthcare professionals practicing in the state meet the necessary qualifications and standards to provide safe and effective care to patients.
Information that must be reported on the Oregon practitioner credentialing application includes education and training background, work experience, licensure and certification information, and references.
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