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

Individual provider Medical Physician Assistant · NPI 1477973204

Stacy Landers, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2013, 13 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon and Washington.

Years since qualifying
13
Licensed in
OR, WA
In the registry since
2014
Specialties on file
3
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

1547 NE 40th Ave Ste B
Portland, OR 97232-1862
Phone: (503) 284-1937
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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 PA168821 (OR)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA61075846 (WA)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA168821 (OR)

Record details

NPI number1477973204
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 19, 2014
Last updated in NPPESJuly 29, 2022
Certification dateJuly 29, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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