Individual provider · Type 1 NPI

Carly Jane King Gravel

Medical Physician Assistant · Portland, OR

NPI number 1629635008 Active

Practice location

3303 S Bond Ave
Portland, OR 97239-4501

Call (503) 494-6594 Map

Fax (503) 494-5385

Mailing address

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

Other practice locations

  • 300 Pasteur Dr, Stanford, CA 94305-2200 · (650) 498-6000

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X58259 (CA)
Medical Physician Assistant Primary 363AM0700XPA207931 (OR)

Medical Physician Assistant: Definition to come...

207 other providers at this address

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About NPI 1629635008

Carly Jane King Gravel's National Provider Identifier is 1629635008, issued on May 21, 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 Sep 18, 2025.