Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GRACE LAKE
ActiveGRACE LAKE is a Physician Assistant healthcare provider located in NEWPORT, Oregon. NPI 1124752233 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · NEWPORT, OR
Registration Details
- NPI Number
- 1124752233
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 13, 2022 (4.0642466262205 yrs)
- Last Updated
- Nov 8, 2024
- License
-
PA221993 (OR)
Practice Information
- Address
-
930 SW ABBEY STNEWPORT, OR, 973654820Browse OR providers · Browse ZIP 97365
- Phone
- 5412652244
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in NEWPORT, OR
| Name | Credential | NPI |
|---|---|---|
| LINELL ELIZABETH WOOD | PA-C | 1366462012 |
| ROBERT CHARLES BARKUS | PA-C | 1700893088 |
| MICHAEL P CRUISE | PA-C | 1275608838 |
| RYAN ALAN HAWLEY | PA-C | 1205951290 |
| JANICE MARLEY JORGENS | PA | 1881821551 |
| ADAM B SHAIN | PA-C | 1679899975 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.