Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mallory Marie McNicholas Dotson, PA-C

Individual provider Medical Physician Assistant · NPI 1114179116

Mallory Marie McNicholas Dotson, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2008, 18 years ago. Practices with Portland Adventist Medical Center, a 272-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
18
Licensed in
OR
In the registry since
2008
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

10000 SE Main St Ste 112
Portland, OR 97216-2448
Phone: (503) 255-3054
Fax: (503) 255-7651
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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 · Licence PA01405 (OR)

Record details

NPI number1114179116
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 21, 2008
Last updated in NPPESFebruary 25, 2025
Certification dateFebruary 25, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Portland Adventist Medical Center — 272 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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