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

Kim R Pederson, MHSPA-C

Individual provider Physician Assistant · NPI 1730278037

Kim R Pederson, MHSPA-C is a Physician Assistant in Vancouver, Washington. Licensed in Maine, Minnesota and Washington. Registered with an NPI since 2006.

Licensed in
ME, MN, WA
In the registry since
2006
Specialties on file
3

Practice location Address checks out

501 SE 172nd Ave
Vancouver, WA 98684-9542
Phone: (360) 882-2778
Fax: (360) 604-1712
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA60511027 (WA)
Physician Assistant Taxonomy 363A00000X · Licence 10200 (MN)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA1356 (ME)

Record details

NPI number1730278037
Entity typeIndividual (Type 1)
GenderFemale
Credentials MHSPA-C
Sole proprietorNo
NPI enumeratedOctober 12, 2006
Last updated in NPPESMarch 3, 2015

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