Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole Elisa Gregoire, PA-C

Individual provider Surgical Physician Assistant · NPI 1437762333

Nicole Elisa Gregoire, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2020, 6 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
6
Licensed in
OR
In the registry since
2020
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

300 N Graham St Ste 125
Portland, OR 97227-1683
Phone: (503) 413-3714
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2900 State St, Medford, OR 97504-8458 — (541) 779-1672

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X (OR)

Record details

NPI number1437762333
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 28, 2020
Last updated in NPPESJune 6, 2024
Certification dateJune 6, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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