Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Antonia Larissa Gragg, PA-C

Individual provider Physician Assistant · NPI 1356658512

Mrs. Antonia Larissa Gragg, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2010, 16 years ago. Practices with University Professional Services, a 1,704-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
16
Licensed in
OR
In the registry since
2010
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

3303 SW Bond Ave CH8N
Portland, OR 97239-4501
Phone: (503) 494-4314
Fax: (503) 346-6810
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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 PA153285 (OR)

Record details

NPI number1356658512
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 9, 2010
Last updated in NPPESJuly 5, 2013

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 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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