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

Kenny Phu

Individual provider Physician Assistant · NPI 1497282289

Kenny Phu is a Physician Assistant in Portland, Oregon. Qualified in 2017, 9 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2017
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Practice location Address checks out

501 N Graham St Ste 580
Portland, OR 97227-2003
Phone: (503) 528-0704
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3517 Ne 42nd Way, Vancouver, WA 98661-3171 — (360) 513-0469

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1497282289
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 11, 2017
Last updated in NPPESJuly 21, 2022
Mailing address501 N Graham St Ste 580, Portland, OR 97227-2003

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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