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Click ‘Get Form’ to open the Oregon Practitioner Credentialing Application 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 principal clinical specialty and whether you wish to be designated as a primary care practitioner.
In the 'Practice Information' section, fill out your current practice details, including addresses and contact numbers. Make sure all information is up-to-date.
Complete the 'Professional Practice/Work History' section chronologically, detailing all relevant work experiences since medical school.
Review the 'Attestation Questions' carefully, answering each question truthfully. This section is crucial for your application’s validity.
Finally, sign and date the application on page 10 and ensure all required documents are attached before submission.

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