Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL VAN WYNGARDEN, PHYSICIAN ASSISTANT
Active Sole ProprietorMICHAEL VAN WYNGARDEN, PHYSICIAN ASSISTANT is a Medical Physician Assistant healthcare provider located in PORTLAND, Oregon. NPI 1790379451 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · PORTLAND, OR
Registration Details
- NPI Number
- 1790379451
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 23, 2021 (5.4299656713505 yrs)
- Last Updated
- Mar 11, 2025
- Licenses
-
PA223530 (OR)PA.0007421 (CO)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3303 S BOND AVEPORTLAND, OR, 972394501Browse OR providers · Browse ZIP 97239
- Phone
- 5034945058
- Fax
- 5034943465
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
- Additional Specialty
- Physician Assistant
Other Medical Physician Assistant Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| IZABELA MACIOLEK | PA-C | 1699771238 |
| PATRICK M BIRBECK | PAC | 1851397400 |
| NICOLE E. PARKER | PA-C | 1669478210 |
| LORI H KELLY | PA-C | 1689670226 |
| ROBERT TODD DIXON | P.A. | 1982602421 |
| ALYSSA RACHAEL PACE | PA-C | 1275527483 |
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.