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

Individual provider Physician Assistant · NPI 1457907974

Kristen Nicole Liebig, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2020, 6 years ago. Practices with Orthopedic and Fracture Clinic PC, a 56-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
6
Licensed in
PA
In the registry since
2019
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

11782 SW Barnes Rd Ste 300
Portland, OR 97225-5933
Phone: (503) 214-5200
Fax: (503) 906-6613
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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 PA221765 (PA)

Record details

NPI number1457907974
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 12, 2019
Last updated in NPPESNovember 25, 2024
Certification dateNovember 25, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Orthopedic And Fracture Clinic Pc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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