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

Justin Scott Fuller, PA

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1609767227

Justin Scott Fuller, PA is a Physician Assistant in Madras, Oregon. Qualified in 2025, 1 year ago. Works from 2 locations.

Years since qualifying
1
In the registry since
2025
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

470 NE A St
Madras, OR 97741-1844
Phone: (541) 475-4800
Fax: (541) 475-4805
Show map & directions

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

Additional practice locations (1)

  • 4311 11th Ave Ne Ste 200, Seattle, WA 98105-6367 — (206) 616-4001

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1609767227
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 11, 2025
Last updated in NPPESApril 16, 2026
Certification dateApril 16, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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