Individual
AINSLEY GRACE PATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10803 SE CHERRY BLOSSOM DRIVE, PORTLAND, OR 97216-3107
(503) 261-7200
(503) 261-7249
Mailing address
10803 SE CHERRY BLOSSOM DRIVE, PORTLAND, OR 97216-3107
(503) 261-7200
(503) 261-7249
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA222081
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500847986
—
OR
Enumeration date
08/30/2022
Last updated
02/20/2025
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