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

Individual provider Family Medicine Physician · NPI 1922825009

Riley Hackley, PA-C is a Physician Assistant in Lebanon, Oregon. Qualified in 2024, 2 years ago. Practices with Mid-Valley Healthcare Inc, a 142-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
2
Licensed in
OR
In the registry since
2024
Specialties on file
2
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

425 N Santiam Hwy
Lebanon, OR 97355-4361
Phone: (541) 451-6960
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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 PA222009 (OR)
Family Medicine Physician Taxonomy 207Q00000X · Licence PA222009 (OR)

Record details

NPI number1922825009
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedSeptember 20, 2024
Last updated in NPPESNovember 25, 2024
Certification dateNovember 25, 2024
Mailing addressPo Box 1189, Corvallis, OR 97339-1189

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Mid-Valley Healthcare Inc — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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