Individual provider Active NPI

Forest Gauthier

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1255165643
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
12121 E Burnside St
Portland, OR 97216-3737
Phone
(971) 361-7700
NPI assigned
Aug 28, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

12121 E Burnside St
Portland, OR 97216-3737

Mailing address

232 NW 6TH Ave
Portland, OR 97209-3609

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
I20250917002300 OR Practitioner - Physician Assistant 1153853551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multnomah CountyGroup PAC ID 6608771787, 111 clinicians

Practice addresses (Care Compare)

600 NE 8TH St
Gresham, OR 97030-7317
Phone (503) 988-7468

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Sep 23, 2025 Accepting new patients
Multnomah County CurrentSince Sep 23, 2025 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-3674

Interoperability endpoints

  • Direct secure messaging: fgauthier832966@direct.ochin.org

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1255165643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 NW 6TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972163737",
            "telephone_number": "971-361-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTHIER",
        "first_name": "FOREST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.