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

Kellie Christine Hergenrader

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1447911540

Kellie Christine Hergenrader is a Physician Assistant in Port Townsend, Washington. Qualified in 2023, 3 years ago. Practices with Jefferson County Public Hospital District No 2, a 150-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
3
Licensed in
WA
In the registry since
2022
Specialties on file
3
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Practice location Address checks out

915 Sheridan St
Port Townsend, WA 98368-2931
Phone: (360) 385-4848
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1086 Canal Dr, Gardnerville, NV 89410-6117 — (775) 781-8300
  • 834 Sheridan St, Port Townsend, WA 98368-2443 — (360) 385-2200

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA61479777 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1447911540
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 1, 2022
Last updated in NPPESApril 16, 2024
Certification dateApril 16, 2024

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 Jefferson County Public Hospital District No 2 — 150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Port Townsend