Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Kelly Marie King, PA

Individual provider Medical Physician Assistant · NPI 1235327883

Mrs. Kelly Marie King, PA is a Physician Assistant in Tigard, Oregon. Qualified in 2007, 19 years ago. Practices with Peacehealth Networks on Demand LLC, a 201-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
19
Licensed in
OR
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

13013 SW Caddy Pl
Tigard, OR 97223-2892
Phone: (503) 766-3263
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence LL17410 (OR)

Record details

NPI number1235327883
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedOctober 9, 2007
Last updated in NPPESOctober 14, 2020
Certification dateOctober 14, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Peacehealth Networks On Demand Llc — 201 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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