Molly Christine McCluskey, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA207464 Issued in OR

Practice address

16083 SW Upper Boones Ferry Rd
130
Tigard, OR 97224

Phone

(503) 603-9087

Fax

(503) 603-9122

NPI assigned

May 2, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Bridgeport Family Medicine LLC

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1205236445
  NPD
• Fornance Physician Services, Inc.

  • Family Medicine Physician
  • Norristown, PA
  • NPI 1013997386
  NPD (past)

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

{
    "created_epoch": "1588377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1376164145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "130",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97224",
            "telephone_number": "503-603-9087",
            "fax_number": "503-603-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16083 SW UPPER BOONES FERRY RD",
            "address_2": "130",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97224",
            "telephone_number": "503-603-9087",
            "fax_number": "503-603-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLUSKEY",
        "first_name": "MOLLY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-02",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA207464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan R McCarthy, PSYD
• Chloe McCaw
• Aaron McChristian
• Matthew Charles McClelland, MD
• Camellia McClendon, NRCPT, NRCMA, CCHT
• Savren Iris McConnell
• Fawn McCool, LCSW
• Maureen Anne McCormick, LCSW
• Julia McCoy
• Leon McCoy

• Physician Assistant in Tigard, OR
• Providers in Tigard, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.