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

Kathy Kiryang Bak, MD

Individual provider Family Medicine Physician · NPI 1861412884

Kathy Kiryang Bak, MD is a Family Practice in Portland, Oregon. Qualified in 2002, 24 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
24
Licensed in
CA, OR
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12400 NW Cornell Rd Ste 100
Portland, OR 97229-5689
Phone: (503) 291-4000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence MD164294 (OR)
Family Medicine Physician Taxonomy 207Q00000X · Licence A91888 (CA)

Record details

NPI number1861412884
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 20, 2006
Last updated in NPPESOctober 27, 2023
Certification dateOctober 27, 2023

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Group practice Providence Health And Services Oregon — 1426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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