Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Adriana Susanna Grimes, PA-C

Individual provider Physician Assistant · NPI 1750001962

Adriana Susanna Grimes, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2023, 3 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
3
Licensed in
OR
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

501 N Graham St Ste 445
Portland, OR 97227-2002
Phone: (503) 944-6300
Fax: (503) 413-4470
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 24900 Se Stark St Ste 202, Gresham, OR 97030-3382 — (503) 944-6300

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA217811 (OR)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1750001962
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 29, 2022
Last updated in NPPESMay 30, 2025
Certification dateMay 30, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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