Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1124752233 Individual Practitioner Female Practitioner

Grace Lake

Physician Assistant • Newport, OR

Professional Overview & Biography Verified Profile Summary

Grace Lake is a registered healthcare professional specializing in Physician Assistant in Newport, OR. Practice services are available at 930 SW ABBEY ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

930 Sw Abbey St

Newport, OR 973654820

Telephone 5412652244
Associated Practice Facility / Clinic
🏢 Larry Wampler Do Pc Facility NPI 1184674210

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Newport, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.9 Yrs
State Avg: 10.5 Yrs
Regional Practice Density
17 Specialists

Practicing in Newport, OR (2106 Statewide)

Telehealth Adoption Rate
5.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-11-08
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License OR PA221993

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Nathan Gruenhagen , MD

Radiology - Diagnostic Radiology

NPI 1013442425

Doctor of Medicine (M.D.)

Dr. Debra Pankiewicz , MD

Internal Medicine

NPI 1013449966

Doctor of Medicine (M.D.)

Donna Cressy , PT

Physical Therapist

NPI 1114295342

Physical Therapist

Dr. Tyler Schulz , DO

Internal Medicine

NPI 1114424454

Doctor of Osteopathic Medicine (D.O.)

Cameron Mcguire , CRNA

Nurse Anesthetist, Certified Registered

NPI 1154876183

Certified Registered Nurse Anesthetist

Dr. Jerry Robbins , MD

Internal Medicine

NPI 1194874040

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 08, 2024

Physician Assistant (License #PA221993 in OR)

📍
Updated Practice Location September 17, 2024

Registered at 930 SW ABBEY ST, NEWPORT, OR 973654820 (Tel: 5412652244)

📍
Updated Business Mailing Address September 17, 2024

Registered at 930 SW ABBEY ST, NEWPORT, OR 973654820

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 17, 2024

Physician Assistant

📍
Updated Practice Location August 19, 2022

Registered at 1100 NORTH AVE, GRAND JUNCTION, CO 815013122 (Tel: 9702481635)

NPI Profile Active July 13, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location July 13, 2022

Registered at 11241 W UTAH PL, LAKEWOOD, CO 802326153 (Tel: 7202025209)

📍
Updated Business Mailing Address July 13, 2022

Registered at 11241 W UTAH PL, LAKEWOOD, CO 802326153

👤
Provider Name / Credentials Updated July 13, 2022

Recorded as GRACE LAKE

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 13, 2022

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration July 13, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124752233
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 13, 2022
Last Update: November 08, 2024
Sole Proprietor: No

Mailing Address

930 Sw Abbey St

Newport, OR 973654820

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.