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

Kamylli J Mendive, PA-C

Individual provider Physician Assistant · NPI 1821653254

Kamylli J Mendive, PA-C is a Physician Assistant in Tigard, Oregon. Graduated from Oregon Health Sciences University School of Medicine in 2020, 6 years ago. Practices with Providence Health and Services Oregon, a 1,426-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and Oregon.

Years since qualifying
6
Trained at
Oregon Health Sciences University School of Medicine
Licensed in
CA, OR
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

12442 SW Scholls Ferry Rd Ste 100
Tigard, OR 97223-0803
Phone: (503) 216-9200
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA202793 (OR)
Physician Assistant Taxonomy 363A00000X · Licence 58813 (CA)

Record details

NPI number1821653254
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 1, 2019
Last updated in NPPESSeptember 30, 2024
Certification dateSeptember 30, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Providence Health And Services Oregon — 1426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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