Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bethany Russotto, PA-C

Individual provider Physician Assistant · NPI 1447891353

Bethany Russotto, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2020, 6 years ago. Practices with University Professional Services, a 1,704-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
6
Licensed in
OR
In the registry since
2019
Specialties on file
4
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

3181 SW Sam Jackson Park Rd # PPV05
Portland, OR 97239-3098
Phone: (714) 449-7400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA208945 (OR)
Physician Assistant Taxonomy 363A00000X · Licence PA208945 (OR)
Physician Assistant Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1447891353
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 2, 2019
Last updated in NPPESJanuary 18, 2022
Certification dateJanuary 18, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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