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

Jared Christian Goodwin

Individual provider Medical Physician Assistant · NPI 1497312128

Jared Christian Goodwin is a Physician Assistant in Gresham, Oregon. Qualified in 2019, 7 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
7
In the registry since
2019

Practice location Address checks out

24988 SE Stark St Ste 220
Gresham, OR 97030-8324
Phone: (503) 674-1580
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1497312128
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 29, 2019
Last updated in NPPESFebruary 11, 2026
Certification dateFebruary 11, 2026
Mailing address24988 Se Stark St Ste 220, Gresham, OR 97030-8324

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations8 on file with Medicare

Other providers in Gresham