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

Taylor Alysa Pottratz

Individual provider Physician Assistant · NPI 1619532884

Taylor Alysa Pottratz is a Physician Assistant in Lake Oswego, Oregon. Qualified in 2020, 6 years ago. Practices with Clear Choice Dermatology, a 48-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
6
Licensed in
OR
In the registry since
2019
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Practice location Address checks out

123 C Ave
Lake Oswego, OR 97034-2353
Phone: (503) 905-9006
Fax: (541) 210-8913
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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 PA204779 (OR)

Record details

NPI number1619532884
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 3, 2019
Last updated in NPPESOctober 4, 2021
Certification dateOctober 1, 2021
Mailing address123 C Ave, Lake Oswego, OR 97034-2353

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Clear Choice Dermatology — 48 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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