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Me9048r Advisory Committee on Physician Credentialing Information (ACPCI) - Oregon Practitioner Recr 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering your full legal name in the 'Practitioner Information' section. Ensure you include any suffixes and provide your contact details accurately.
- Proceed to the 'Specialty Information' section. Indicate your primary clinical specialty and check if you wish to be designated as a primary care practitioner.
- In the 'Board Certification/Recertification' section, list all current and past certifications. If necessary, attach additional sheets for more information.
- Complete the 'Practice and Employment Information' section with details about your primary practice, including contact numbers and addresses.
- Review each section carefully, ensuring all fields are filled out completely. Remember to initial each page and sign where required before submission.
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