Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Wulf, PA-C

Individual provider Dermatology Physician · NPI 1750654323

Kelly Wulf, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2013, 13 years ago. Practices with Clackamas Dermatology PC, an 11-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
13
Licensed in
OR
In the registry since
2012
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2565 NW Lovejoy St Ste 100
Portland, OR 97210-2996
Phone: (503) 279-9700
Fax: (503) 279-8114
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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 PA164512 (OR)
Dermatology Physician Taxonomy 207N00000X · Licence PA164512 (OR)
Physician Assistant Taxonomy 363A00000X · Licence PA164512 (OR)

Record details

NPI number1750654323
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 13, 2012
Last updated in NPPESNovember 8, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Clackamas Dermatology Pc — 11 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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