MEDICARE: TRINA GALE NESTOR PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA228227	OR
2	363AM0700X	Medical Physician Assistant	01097	WV

General Provider Information

NPI Number	:	1093987349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINA GALE NESTOR PA-C

Provider Business Mailing Address
First Line	:	527 MEDICAL PARK DR STE 304
Second Line	:
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-9010
Country	:	US
Telephone Number	:	304-842-0007
Fax Number	:

Provider Business Practice Location Address
First Line	:	1510 DIVISION ST STE 200
Second Line	:
City	:	OREGON CITY
State	:	OR
Zip	:	97045-1599
Country	:	US
Telephone Number	:	503-962-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2008
Last Update Date	:	02/09/2026

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Directions to “ TRINA GALE NESTOR PA-C” Practice Location

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