Jesse David Winslow Russell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA203927 Issued in OR

Practice address

1185 S Elm St
Canby, OR 97013-3935

Phone

(503) 723-4660

Fax

(503) 266-6649

NPI assigned

Sep 13, 2021

Sex

Male

Sole proprietor

No

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

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Willamette Falls Medical Center Hospital, Oregon City, OR, CCN 380038

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Praxis Health, PC

  • Multi-Specialty Clinic/Center
  • Bend, OR
  • NPI 1821068164

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Oregon Healthcare Resources, LLC

  • Multi-Specialty Clinic/Center
  • Eugene, OR
  • NPI 1982907572
  Medicare reassignment NPD
• Oregon Healthcare Resources, LLC

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1215761002
  NPD
• Praxis Health, PC

  • Rural Health Clinic/Center
  • Dallas, OR
  • NPI 1942925326
  NPD

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

• Providence Health & Services - Oregon

  • Clinic/Center
  • Portland, OR
  • NPI 1326272741

  Hospital

  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Oregon City, OR
  • NPI 1912282369
  Care Compare affiliation

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1659040590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 S ELM ST",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133935",
            "telephone_number": "503-723-4660",
            "fax_number": "503-266-6649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 N Grant St",
            "address_purpose": "LOCATION",
            "city": "Canby",
            "state": "OR",
            "postal_code": "970133689",
            "country_code": "US",
            "telephone_number": "503-266-2066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JESSE",
        "middle_name": "DAVID WINSLOW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-13",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA203927",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "PA203927",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Stephanie Rodriguez, MD
• Roger D Stewart DC PC
• Deidre Rosier
• Maximilian Ruiz Dezarate
• Abby Jean Russell
• Victoria Saager
• Emily Dean Sanborn, LPC REGISTEED INTERN
• Jessica Leigh Sappenfield
• Catherine Mary Saunders, MA, LPC
• Nathan Denson Savage-Lee

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.