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

Individual provider Physician Assistant · NPI 1073685285

Mr. Derek Hennessy, PA-C is a Physician Assistant in Spokane, Washington. Qualified in 2004, 22 years ago. Practices with Kaiser Foundation Health Plan of Washington, a 1,519-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
22
Licensed in
WA
In the registry since
2006
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

322 W North River Dr
Spokane, WA 99201-3208
Phone: (509) 276-5005
Fax: (509) 276-7785
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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 PA10004720 (WA)

Record details

NPI number1073685285
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 14, 2006
Last updated in NPPESApril 13, 2021
Certification dateApril 13, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Kaiser Foundation Health Plan Of Washington — 1519 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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