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

Individual provider Surgical Physician Assistant · NPI 1154763050

Michelle Renae-Pippel Keller, PA-C is a Physician Assistant in Corvallis, Oregon. Qualified in 2013, 13 years ago. Practices with Icco LLC, a 133-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
13
Licensed in
OR
In the registry since
2013
Specialties on file
2
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

3615 NW Samaritan Dr Ste 210
Corvallis, OR 97330-3783
Phone: (541) 768-4501
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA173678 (OR)
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1154763050
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 22, 2013
Last updated in NPPESJanuary 14, 2021
Certification dateJanuary 14, 2021

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 Icco Llc — 133 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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