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

Katherine Vestakis

Individual provider Physician Assistant · NPI 1154082022

Katherine Vestakis is a Physician Assistant in Gresham, Oregon. Qualified in 2023, 3 years ago. Practices with Legacy Mount Hood Medical Center, a 58-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
3
Licensed in
OR
In the registry since
2022
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Practice location Address checks out

24988 SE Stark St Ste 220
Gresham, OR 97030-8324
Phone: (503) 674-1580
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Pa Program, 240 E Huron St Ste 1-200, Chicago, IL 60611-2909 — (312) 503-1851

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA217362 (OR)

Record details

NPI number1154082022
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 4, 2022
Last updated in NPPESMay 6, 2024
Certification dateMay 6, 2024
Mailing addressPo Box 4365, Portland, OR 97208-4365

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 Legacy Mount Hood Medical Center — 58 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Gresham