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

Bruce Fernstrom, PA-C

Individual provider Physician Assistant · NPI 1255329967

Bruce Fernstrom, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2001, 25 years ago. Practices with Legacy Good Samaritan Hospital and Medical Center, a 192-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
25
Licensed in
OR
In the registry since
2005
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 420
Portland, OR 97227-2006
Phone: (503) 288-7303
Fax: (503) 288-3806
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1130 Nw 22nd Ave Ste 400, Portland, OR 97210-2971 — (503) 413-6722
  • 19250 Sw 65th Ave Ste 235, Tualatin, OR 97062-7745 — (503) 692-4820

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA00805 (OR)
Physician Assistant Taxonomy 363A00000X · Licence PA00805 (OR)

Record details

NPI number1255329967
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 7, 2005
Last updated in NPPESJuly 28, 2025
Certification dateJuly 28, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Legacy Good Samaritan Hospital And Medical Center — 192 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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