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

Michael Van Wyngarden, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1790379451

Michael Van Wyngarden, PHYSICIANASSISTANT is a Physician Assistant in Portland, Oregon. Qualified in 2022, 4 years ago. Practices with University Professional Services, a 1,704-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Colorado and Oregon.

Years since qualifying
4
Licensed in
CO, OR
In the registry since
2021
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

3303 S Bond Ave
Portland, OR 97239-4501
Phone: (503) 494-5058
Fax: (503) 494-3465
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (1)

  • 3181 Sw Sam Jackson Park Rd # Oc14ho, Portland, OR 97239-3011 — (503) 494-7999

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA223530 (OR)
Physician Assistant Taxonomy 363A00000X · Licence PA.0007421 (CO)

Record details

NPI number1790379451
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedFebruary 23, 2021
Last updated in NPPESMarch 11, 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 2022 (4 years in practice)
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Portland