A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally...
ID license #9271657OR license #PA226339taxonomy 363A00000X
Identifiers
Type
Value
Notes
05 (OR)
500862825
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Medicare directory context
Attributes below come from the CMS Doctors & Clinicians dataset used by Medicare Care Compare,
retrieved 2026-08-21. They apply only to this clinician's public Medicare listing.
Medicare specialties
Physician Assistant
Largest Medicare group
45 members
Largest listed enrollment group
Facility affiliations reported by CMS
Valley Family Health Care Inc
Medicare listing data does not guarantee that a clinician is accepting new patients or that a service is covered.
View the CMS dataset →
Practice context
Part of a multi-provider practice. 23 other active providers share this practice address in NPPES.
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