Individual provider Active NPI

Nicolette Paradis

  • Physician Assistant
  • Portland, OR
National Provider Identifier
1679485072
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
12556 NW Lilywood Dr
Portland, OR 97229-8515
Phone
(503) 702-8030
NPI assigned
Sep 21, 2026
Last updated
Sep 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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 WA Primary

Addresses

Primary practice location

12556 NW Lilywood Dr
Portland, OR 97229-8515

Mailing address

12556 NW Lilywood Dr
Portland, OR 97229-8515
Phone (503) 702-8030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789948800000",
    "number": "1679485072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12556 NW LILYWOOD DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972298515",
            "telephone_number": "503-702-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12556 NW LILYWOOD DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972298515",
            "telephone_number": "503-702-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARADIS",
        "first_name": "NICOLETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.