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

Mr. Michael Dean Mallon

Individual provider Medical Physician Assistant · NPI 1194121715

Mr. Michael Dean Mallon is a Physician Assistant in Portland, Oregon. Graduated from Oregon Health Sciences University School of Medicine in 2023, 3 years ago. Practices with University Professional Services, a 1,704-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
3
Trained at
Oregon Health Sciences University School of Medicine
Licensed in
OR
In the registry since
2014
Specialties on file
3
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Practice location Address checks out

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-3273
Fax: (503) 418-2208
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 2730 S Moody Ave, Portland, OR 97201-5042 — (503) 725-3442
  • 3415 Se Powell Blvd, Portland, OR 97202-3371 — (503) 234-9591

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA218438 (OR)
Counselor Taxonomy 101Y00000X (OR)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1194121715
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 10, 2014
Last updated in NPPESJuly 10, 2024
Certification dateJuly 10, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated 2023 (3 years in practice)
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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