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

Keeona G Vance

Individual provider Nurse Practitioner · NPI 1528636156

Keeona G Vance is a Nurse Practitioner in Portland, Oregon. Qualified in 2022, 4 years ago. Practices with Legacy Clinics LLC, a 718-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
4
Licensed in
OR
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: (503) 813-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 202208494NP-PP (OR)
Nurse Practitioner Taxonomy 363L00000X · Licence 202208494NP-PP (OR)

Record details

NPI number1528636156
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 10, 2021
Last updated in NPPESOctober 12, 2023
Certification dateOctober 12, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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