Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samuel Bryan Valdivia

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1003439084

Samuel Bryan Valdivia is a Physician Assistant in Portland, Oregon. Qualified in 2022, 4 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
4
Licensed in
OR
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

501 N Graham St Medical Ofc Bldg 2 Ste 220
Portland, OR 97227
Phone: (503) 413-6200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 222 Se 8th Ave Ste 536, Hillsboro, OR 97123-4218 — (503) 352-7272
  • 1701 Sw Columbia St Apt 404, Portland, OR 97201-2592 — (602) 403-5363

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA213719 (OR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1003439084
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 25, 2020
Last updated in NPPESOctober 28, 2022
Certification dateSeptember 23, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Portland