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

Lisa Blakley, PA

Individual provider Physician Assistant · NPI 1649031642

Lisa Blakley, PA is a Physician Assistant in Portland, Oregon. Qualified in 2024, 2 years ago. Practices with Epiphany Dermatology of Oregon LLC, a 3-clinician group. Licensed in Oregon.

Years since qualifying
2
Licensed in
OR
In the registry since
2024
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2222 NW Lovejoy St Ste 422
Portland, OR 97210-5102
Phone: (503) 227-7117
Fax: (503) 227-7120
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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 PA220196 (OR)

Record details

NPI number1649031642
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 17, 2024
Last updated in NPPESFebruary 24, 2025
Certification dateFebruary 24, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Epiphany Dermatology Of Oregon Llc — 3 clinicians
Accepts Medicare assignment Not indicated

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