Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Kimberly P Boe, PA-C

Individual provider Surgical Physician Assistant · NPI 1144523473

MS. Kimberly P Boe, PA-C is a Physician Assistant in Portland, Oregon. Qualified in 2009, 17 years ago. Practices with Legacy Clinics LLC, a 718-clinician group and accepts Medicare assignment. Licensed in Oregon and Washington.

Years since qualifying
17
Licensed in
OR, WA
In the registry since
2010
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

501 N Graham St Ste 415
Portland, OR 97227-1654
Phone: (503) 413-3580
Fax: (503) 413-3578
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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 172044 (OR)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 60615487 (WA)

Record details

NPI number1144523473
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 8, 2010
Last updated in NPPESDecember 9, 2022
Certification dateDecember 7, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

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