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

Liesel Ernst

Individual provider Physician Assistant · NPI 1417226382

Liesel Ernst is a Physician Assistant in Medford, Oregon. Qualified in 2011, 15 years ago. Practices with Clinic for Dermatology and Wellness LLC, a 6-clinician group and accepts Medicare assignment. Licensed in California, Minnesota and Oregon.

Years since qualifying
15
Licensed in
CA, MN, OR
In the registry since
2011
Specialties on file
3
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Practice location Address checks out

2924 Siskiyou Blvd Ste 200
Medford, OR 97504-6462
Phone: (541) 200-2777
Fax: (541) 214-2575
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA184560 (OR)
Physician Assistant Taxonomy 363A00000X · Licence 55040 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 1645 (MN)

Record details

NPI number1417226382
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 22, 2011
Last updated in NPPESMarch 9, 2024
Certification dateMarch 9, 2024
Mailing address2924 Siskiyou Blvd Ste 200, Medford, OR 97504-6462

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Clinic For Dermatology And Wellness Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Medford