NPIMap

Individual provider Active NPI

Grace Deng Keim, PA-C

  • Surgical Physician Assistant
  • Vancouver, WA
National Provider Identifier
1073996823
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
210 SE 136TH Ave
Vancouver, WA 98684-6930
Phone
(360) 597-1313
NPI assigned
Jun 29, 2015
Last updated
Dec 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X NU Primary

Addresses

Primary practice location

210 SE 136TH Ave
Vancouver, WA 98684-6930

Mailing address

1498 SE Tech Center PL Ste 240
Vancouver, WA 98683-5508
Phone (360) 597-1313

Other names 1

  • Grace Deng Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151012001705 WA Practitioner - Physician Assistant 7517276645 Reassigns benefits to 3 organizations
I20190325000747 OR Practitioner - Physician Assistant 7517276645 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Cancer Specialists PCGroup PAC ID 8426943838, 70 clinicians

Practice addresses (Care Compare)

12123 SW 69TH Ave
Tigard, OR 97223-8514
Phone (971) 708-7600

210 SE 136TH Ave
Vancouver, WA 98684-6930
Phone (360) 944-9889

265 N Broadway
Portland, OR 97227-1800
Phone (503) 280-1223

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sapphire at Gresham Rehab, LLC CurrentSince Mar 4, 2019 Accepting new patients
Northwest Cancer Specialists PC CurrentSince Jan 18, 2023 Accepting new patients
Peacehealth CurrentSince Sep 14, 2015 Accepting new patients
Manor Care of Salmon Creek Wa, Association CurrentSince Mar 4, 2019 Accepting new patients
Northwest Cancer Specialists PC CurrentSince Jan 18, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Mar 4, 2019 Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

265 N Broadway
Portland, OR 97227
Phone (503) 280-1223

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

1498 SE Tech Center Pl
Ste 240
Vancouver, WA 98683
Phone (360) 597-1309

210 SE 136th Ave
Vancouver, WA 98684
Phone (360) 944-9889

505 NE 87th Ave
Ste 250
Vancouver, WA 98664
Phone (360) 514-1010

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: gkeim158382@direct.ohsu.edu
  • Direct secure messaging: grace.keim@compass.ikm.direct-ci.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1073996823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1498 SE TECH CENTER PL STE 240",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835508",
            "telephone_number": "360-597-1313",
            "fax_number": "360-597-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SE 136TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846930",
            "telephone_number": "360-597-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIM",
        "first_name": "GRACE",
        "middle_name": "DENG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GRACE",
            "last_name": "DENG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.