Grace Lake
Physician Assistant · Newport, OR
Practice location
930 SW Abbey StNewport, OR 97365-4820
- Phone
- (541) 265-2244
NPI record
- NPI
- 1124752233
- Entity type
- Individual (Type 1)
- Enumeration date
- July 13, 2022
- Last updated
- November 8, 2024
- Certified
- November 8, 2024
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X |
PA221993 | OR |
About Grace Lake
Grace Lake is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 930 SW Abbey St, Newport, OR 97365-4820. The NPI number 1124752233 was assigned on July 13, 2022 and the record was last updated on November 8, 2024.
Grace Lake lists a license in the registry: #PA221993 (OR) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Grace Lake?
The NPI number is 1124752233.
What is the phone number of Grace Lake?
The phone number listed for the practice location is (541) 265-2244.
Where is Grace Lake located?
930 SW Abbey St, Newport, OR 97365-4820.
What is the taxonomy code for Grace Lake?
The primary taxonomy code is 363A00000X – Physician Assistant.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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