Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Nathan Wade Fennewald, PA-C

Individual provider Physician Assistant · NPI 1386004521

Mr. Nathan Wade Fennewald, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2015, 11 years ago. Practices with University Professional Services, a 1,704-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
11
Licensed in
OR
In the registry since
2016
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

3181 SW Sam Jackson Park Rd # OP31 Orthopedics & Rehabilitation Dept
Portland, OR 97239-3011
Phone: (636) 688-9260
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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 PA176237 (OR)

Record details

NPI number1386004521
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedMarch 1, 2016
Last updated in NPPESMarch 1, 2016

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice University Professional Services — 1704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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