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

Individual provider Physician Assistant · NPI 1043717390

Rayna Donnelly, PA-C is a Physician Assistant in Tigard, Oregon. Qualified in 2017, 9 years ago. Practices with Mountain West Derm - Blackhart PLLC, a 103-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
9
Licensed in
OR
In the registry since
2018
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

9735 SW Shady Ln Ste 102
Tigard, OR 97223
Phone: (503) 620-5614
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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 PA185400 (OR)

Record details

NPI number1043717390
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 11, 2018
Last updated in NPPESJuly 25, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Mountain West Derm - Blackhart Pllc — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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