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

Individual provider Physician Assistant · NPI 1396817458

Ella Clark-Nicholson, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2006, 20 years ago. Practices with University Professional Services, a 1,704-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
20
Licensed in
OR
In the registry since
2006
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

3303 SW Bond Ave
Portland, OR 97239-4501
Phone: (503) 494-8573
Fax: (503) 494-3457
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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
Physician Assistant Taxonomy 363A00000X · Licence PA01168 (OR)

Record details

NPI number1396817458
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 14, 2006
Last updated in NPPESFebruary 8, 2021
Certification dateFebruary 8, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2006 (20 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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