Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jeffrey Allan Koller, PA-C

Individual provider Physician Assistant · NPI 1215790639

Jeffrey Allan Koller, PA-C is a Physician Assistant in Sublimity, Oregon. Qualified in 2023, 3 years ago. Practices with Santiam Memorial Hospital, a 125-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
3
Licensed in
OR
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

114 SE Church St
Sublimity, OR 97385-9424
Phone: (503) 769-2259
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA218511 (OR)

Record details

NPI number1215790639
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 31, 2024
Last updated in NPPESDecember 22, 2025
Certification dateDecember 22, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Santiam Memorial Hospital — 125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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