OrganizationActive
The Jackson Macy Clinic LLC
NPI 1780390864 · Advanced Practice Midwife · Tualatin, OR
Provider details
- NPI number
- 1780390864
- Entity type
- Organization
- Primary specialty
- Advanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Kelly Grant, Owner(503) 724-8188
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Women's Health Nurse Practitioner363LW0102X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
19365 Sw 65th Ave Ste 105
Tualatin, OR 97062-9196
Phone: (503) 454-0018
Fax: (503) 848-3471
Street-level locationGet directions
Mailing address
19365 Sw 65th Ave Ste 105
Tualatin, OR 97062-9196
Other names (DBA / former)
- Doing business as
- The Jackson Macy Clinic
Registry dates
- Enumerated
- 2023-01-23
- Last updated
- 2023-11-21
- Certified
- 2023-11-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.