Individual provider · Type 1 NPI

Megan Elisabeth Gravelyn, PA-C

Medical Physician Assistant · Portland, OR

NPI number 1407404833 Active

Practice location

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3098

Call (503) 494-5058 Map

Mailing address

1400 SW 5th Ave Ste 500
Portland, OR 97201-5537

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA61341909 (WA)
Medical Physician Assistant Primary 363AM0700XPA230310 (OR)

Medical Physician Assistant: Definition to come...

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About NPI 1407404833

Megan Elisabeth Gravelyn, PA-C's National Provider Identifier is 1407404833, issued on Aug 28, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Portland, OR. The record was last updated on Aug 12, 2026.