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

Individual provider Physician Assistant · NPI 1740617729

Mr. Ronald William Keller Jr., 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 and Pennsylvania.

Years since qualifying
13
Licensed in
OR, PA
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

990 NW Circle Blvd Ste 102
Corvallis, OR 97330-1967
Phone: (541) 768-5486
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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 PA172141 (OR)
Physician Assistant Taxonomy 363A00000X · Licence MA056511 (PA)

Record details

NPI number1740617729
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 4, 2013
Last updated in NPPESNovember 10, 2020
Certification dateNovember 10, 2020

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 locations9 on file with Medicare

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