MRS. ANTONIA LARISSA GRAGG


Address: 3303 Sw Bond Ave, Ch8n, Portland, OR 97239-4501
Phone: 5034944314

MRS. ANTONIA LARISSA GRAGG (NPI# 1356658512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356658512
Entity Type Individual
Full Name MRS. ANTONIA LARISSA GRAGG
Other Name ANTONIA LARISSA SOINEY
Credential PA-C
Practice Address 3303 Sw Bond Ave
Ch8n
Portland
OR 97239-4501
Practice Telephone 5034944314
Practice Fax Number 5033466810
Mailing Telephone 5034944314
Mailing Fax Number 5033466810
Enumeration Date 2010-09-09
Last Update Date 2013-07-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant PA153285 OR Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR 500635914 05
WA 1356658512 05

Office Location

Street Address 3303 SW BOND AVE
CH8N
City PORTLAND
State OR
Zip Code 97239-4501

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639174287 Dawn F. Tilgner Nurse Practitioner 3303 Sw Bond Ave, Portland, OR 97239-4501 2005-06-19
1376164582 Marisa Palandri Occupational Therapist 3303 Sw Bond Ave, Portland, OR 97239-4501 2020-04-28
1194345629 Margaret Alva Mcreynolds Physical Therapist 3303 Sw Bond Ave, Portland, OR 97239-4501 2020-04-24
1104446392 Jennifer Crawford Occupational Therapist 3303 Sw Bond Ave, Portland, OR 97239-4501 2020-04-17
1093335275 Mehak Noorani Speech-Language Pathologist 3303 Sw Bond Ave, Portland, OR 97239-4501 2020-04-17
1497374185 Ruth Semon Physical Therapist 3303 Sw Bond Ave, Portland, OR 97239-4501 2020-04-13
1649899675 Kristin Moore Physical Therapist 3303 Sw Bond Ave, Portland, OR 97239-4501 2020-04-09
1821627266 Mollie Ann Suits Physical Therapist 3303 Sw Bond Ave, Portland, OR 97239-4501 2020-04-07
1801425269 Andrea Susan Serdar Physical Therapist 3303 Sw Bond Ave, Portland, OR 97239-4501 2020-04-06
1508495037 Chante Noel Larlee Physical Therapist 3303 Sw Bond Ave, Portland, OR 97239-4501 2020-04-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1558979468 Elise Caitlin Esposito Student in an Organized Health Care Education/Training Program 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 2020-07-16
1750908844 Will Cowan Student in an Organized Health Care Education/Training Program 455 Sw Us Veterans Hospital Road., Portland, OR 97239 2020-07-06
1881219657 Desiree Baer Licensed Vocational Nurse Sw Us Veterans Hospital Rd, Portland, OR 97239 2020-06-08
1285266205 Melissa Irene Wheeler Registered Nurse Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 2020-02-07
1225687981 Pheba Mariam Jones Pharmacist Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 2019-09-05
1801448063 Alice Huang Huang Student in an Organized Health Care Education/Training Program 3710 Sw Veterans Road, Portland, OR 97239 2019-07-09
1710446273 Ellen Noreen Kessi Social Worker 3710 Sw Us Veterans Rd., Portland, OR 97239 2019-03-14
1508335704 Jacqueline Marie Mular Marriage & Family Therapist 5550 Sw Macadam Suite 100, Portland, OR 97239 2018-11-16
1275030926 Carly Elizabeth Dougher Student in an Organized Health Care Education/Training Program Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 2018-04-10
1780188094 Dennis John Samuel Student in an Organized Health Care Education/Training Program Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 2018-03-21
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

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 trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1427676493 Lindsey Louise Peterson Physician Assistant 3505 N Williams Ave, Portland, OR 97227-1437 2020-07-07
1518584036 Abigail Nichole Dumont Physician Assistant 6064 Sw 30th Ave, Portland, OR 97239-1018 2020-06-30
1336769637 Molly Tanguay Physician Assistant 23 Bramhall St, Portland, ME 04102-3121 2020-04-16
1063040525 Jessica Nursick Physician Assistant 26 Sand Hill Rd, Portland, CT 06480-1737 2020-03-31
1689217630 Evan Eisher Physician Assistant 3809 Se Stephens St, Portland, OR 97214-5248 2019-10-22
1508407941 Amie Bates Physician Assistant 1040 Nw 22nd Ave # Ll030, Portland, OR 97210-3057 2019-10-07
1558923326 Mackenzie Graye Mcmillin Physician Assistant 1601 Congress St Ste 1, Portland, ME 04102-2145 2019-07-02
1447812268 Maksim Yefimov Physician Assistant 2800 N Vancouver Ave Ste 130, Portland, OR 97227 2019-07-01
1942794839 Michael Peterson Physician Assistant 3181 Sw Sam Jackson Park Rd # P31, Portland, OR 97239-3098 2018-06-14
1306383930 Rachel Lynn Witowski Physician Assistant 2124 Nw Hoyt St, Portland, OR 97210-3215 2017-01-20
Find all providers in PORTLAND

Competitor

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City PORTLAND
Zip Code 97239

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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