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

Jerry Wang, OP

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1376119883

Jerry Wang, OP is a Family Practice in Portland, Oregon. Graduated from Touro Un Col of Osteopathic Medicine, Henderson in 2021, 5 years ago. Practices with Kaiser Foundation Health Plan of the Northwest, a 1,811-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
5
Trained at
Touro Un Col of Osteopathic Medicine, Henderson
Licensed in
WA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

3550 N Interstate Ave
Portland, OR 97227-1196
Phone: (321) 576-8536
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1806 W Lincoln Ave, Yakima, WA 98902-2473 — (509) 452-4520

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence OP61170696 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence OP61170696 (WA)

Record details

NPI number1376119883
Entity typeIndividual (Type 1)
GenderMale
Credentials OP
Sole proprietorNo
NPI enumeratedJune 3, 2021
Last updated in NPPESSeptember 24, 2024
Certification dateSeptember 24, 2024
Mailing address3550 N Interstate Ave, Portland, OR 97227-1196

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolTOURO UN COL OF OSTEOPATHIC MEDICINE, HENDERSON
Graduated 2021 (5 years in practice)
Group practice Kaiser Foundation Health Plan Of The Northwest — 1811 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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