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

Kelly Rene Keller, PA

Individual provider Physician Assistant · NPI 1093916744

Kelly Rene Keller, PA is a Physician Assistant in Portland, Oregon. Licensed in Oregon and Texas. Registered with an NPI since 2007.

Licensed in
OR, TX
In the registry since
2007
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3181 SW Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 418-5710
Fax: (503) 494-4953
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA152808 (OR)
Physician Assistant Taxonomy 363A00000X · Licence PA04395 (TX)

Record details

NPI number1093916744
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 30, 2007
Last updated in NPPESDecember 29, 2020
Certification dateDecember 29, 2020

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