Blake A Nelson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA217352 Issued in OR

Practice address

9300 SE 91St Ave Ste 200
Happy Valley, OR 97086-3762

Phone

(503) 261-1171

Fax

(503) 253-5989

NPI assigned

Jun 23, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bnelson1524456@direct.lhs.org

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.

• Metropolitan Pediatrics, LLC

  • Pediatrics Physician
  • Portland, OR
  • NPI 1235131632
  NPD (past)

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1437880010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 SE 91ST AVE STE 200",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970863762",
            "telephone_number": "503-261-1171",
            "fax_number": "503-253-5989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 SE 91ST AVE STE 200",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970863762",
            "telephone_number": "503-261-1171",
            "fax_number": "503-253-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BLAKE",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA217352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason L Murray, D.D.S.
• Monica K Myklebust, MD
• Sage Luna Nebula, CADC-II, QMHA, CRM
• Need 4 Narcan Join Our Mission
• Raymond Negus, D.C.
• Heidi Neubig, B.S.
• New Seasons Market - Happy Valley
• Newstart Community Development
• Daniel Phan Nguyen, DDS
• Michelle Yen Nguyen

• Physician Assistant in Happy Valley, OR
• Providers in Happy Valley, OR by specialty
• Physician Assistant in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.