Individual provider Active NPI

Rachel Dawn Nyquist

  • Medical Physician Assistant
  • Junction City, OR
National Provider Identifier
1134922628
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA227485 Issued in OR
Practice address
355 W 3Rd Ave
Junction City, OR 97448-1313
Phone
(541) 998-6750
Fax
(541) 998-8270
NPI assigned
Mar 31, 2025
Last updated
Oct 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA227485 OR Primary

Addresses

Primary practice location

355 W 3Rd Ave
Junction City, OR 97448-1313

Mailing address

355 W 3Rd Ave
Junction City, OR 97448-1313
Phone (541) 998-6750

Other practice location 1

1233 Deerfield Pkwy Apt 302
Buffalo Grove, IL 60089-2626
Phone (425) 223-2887

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251025000294 OR Practitioner - Physician Assistant 2860981354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icco LLCGroup PAC ID 1355406729, 133 clinicians

Practice addresses (Care Compare)

355 W 3Rd Ave
Junction City, OR 97448-1313
Phone (541) 998-6750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA227485ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Icco, LLC Current Accepting new patients
Icco LLC CurrentSince Nov 18, 2025 Accepting new patients
Icco, LLC Past Accepting new patients

Locations

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3675 Pacific Ave
#101
Forest Grove, OR 97116
Phone (971) 762-4611

1890 NW 6th St
Grants Pass, OR 97526
Phone (541) 507-0684

355 W 3rd Ave
Junction City, OR 97448
Phone (541) 998-2468

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

3400 Cooperative Way
Lebanon, OR 97355
Phone (541) 333-6605

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1134922628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 W 3RD AVE",
            "city": "JUNCTION CITY",
            "state": "OR",
            "postal_code": "974481313",
            "telephone_number": "541-998-6750",
            "fax_number": "541-998-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 W 3RD AVE",
            "city": "JUNCTION CITY",
            "state": "OR",
            "postal_code": "974481313",
            "telephone_number": "541-998-6750",
            "fax_number": "541-998-8270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1233 Deerfield Pkwy Apt 302",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "600892626",
            "country_code": "US",
            "telephone_number": "425-223-2887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYQUIST",
        "first_name": "RACHEL",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-31",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA227485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Junction City, OR

Sources for this page

Verify at the official NPI Registry.