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

Stacey Ann Williamson, PA-C

Individual provider Physician Assistant · NPI 1457667891

Stacey Ann Williamson, PA-C is a Physician Assistant in Tigard, Oregon. Qualified in 2010, 16 years ago. Practices with Fairview Heights Medical Group SC, a 448-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Illinois, Missouri and Oregon.

Years since qualifying
16
Licensed in
IL, MO, OR
In the registry since
2010
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

12442 SW Scholls Ferry Rd Ste 100
Tigard, OR 97223-0803
Phone: (503) 216-9200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 2122 Troy Rd Ste 130, Edwardsville, IL 62025-2540 — (618) 692-9876
  • 11155 Dunn Rd Ste 109n, Saint Louis, MO 63136-6148 — (314) 953-8799
  • 9155 Sw Barnes Rd Ste 638, Portland, OR 97225-6633 — (503) 216-7000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA178932 (OR)
Physician Assistant Taxonomy 363A00000X · Licence 2020025684 (MO)
Physician Assistant Taxonomy 363A00000X · Licence 085008245 (IL)

Record details

NPI number1457667891
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 24, 2010
Last updated in NPPESJuly 6, 2021
Certification dateJuly 6, 2021

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 Fairview Heights Medical Group Sc — 448 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Tigard