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

Individual provider Physician Assistant · NPI 1760104855

Kimberly Edmonds, PA-C is a Physician Assistant in Stayton, Oregon. Qualified in 2023, 3 years ago. Practices with Santiam Memorial Hospital, a 125-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
3
Licensed in
OR
In the registry since
2022
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

1401 N 10th Ave Ste 100
Stayton, OR 97383-1486
Phone: (503) 769-6386
Fax: (503) 769-5647
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA218013 (OR)

Record details

NPI number1760104855
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 14, 2022
Last updated in NPPESJanuary 26, 2024
Certification dateJanuary 26, 2024
Mailing address4777 Whitman Cir Ne, Salem, OR 97305-3600

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 Santiam Memorial Hospital — 125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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