Individual provider Active NPI

Angela M Kline, PA-C

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1083788483
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
70111806 Issued in WA
Practice address
1499 SE Tech Center PL Ste 190
Vancouver, WA 98683-5529
Phone
(360) 828-7802
Fax
(360) 326-2606
NPI assigned
Nov 17, 2006
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 70111806 WA Primary

Addresses

Primary practice location

1499 SE Tech Center PL Ste 190
Vancouver, WA 98683-5529

Mailing address

16420 SE McGillivray Blvd Ste 103
Vancouver, WA 98683-3599
Phone (360) 828-7802

Other practice location 1

8524 Steilacoom Blvd SW Ste 102B
Lakewood, WA 98498-4772
Phone (360) 828-7802

Other practice location 2

2621 NE 134th St Ste 200
Vancouver, WA 98686-3036
Phone (360) 828-7802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130219000387 NE Practitioner - Physician Assistant 0749376960 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ven Whole Healthcare LLCGroup PAC ID 9234521980, 6 clinicians
Pacific Phoenix Group PLLCGroup PAC ID 5799148854, 8 clinicians

Practice addresses (Care Compare)

13917 Gold Cir
Omaha, NE 68144-2359
Phone (402) 991-9630

7655 Archer PL
Lincoln, NE 68516-5286
Phone (402) 413-9770

8524 Steilacoom Blvd SW
Suite 102B
Lakewood, WA 98498-4772
Phone (360) 828-7802

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
844NEMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Phoenix Group PLLC CurrentSince Jun 15, 2026 Accepting new patients
Omaha Insomnia and Psychiatric Services, LLC CurrentSince Oct 11, 2024 Accepting new patients
Lutheran Family Services of NE, Inc PastSince Nov 18, 2025 Accepting new patients
Alegent Health Immanuel Medical Center Past Accepting new patients
Alegent Health Immanuel Medical Center Past Accepting new patients

Locations

13917 Gold Cir
Omaha, NE 68144
Phone (402) 991-9630

8524 Steilacoom Blvd SW
Ste 102B
Lakewood, WA 98498
Phone (253) 237-3348

1499 SE Tech Center Pl
Ste 190
Vancouver, WA 98683
Phone (360) 773-6340

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1083788483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16420 SE MCGILLIVRAY BLVD STE 103",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833599",
            "telephone_number": "360-828-7802",
            "fax_number": "360-326-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1499 SE TECH CENTER PL STE 190",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835529",
            "telephone_number": "360-828-7802",
            "fax_number": "360-326-2606"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8524 Steilacoom Blvd SW Ste 102B",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984984772",
            "country_code": "US",
            "telephone_number": "360-828-7802",
            "fax_number": "360-326-2606",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2621 NE 134th St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986863036",
            "country_code": "US",
            "telephone_number": "360-828-7802",
            "fax_number": "360-326-2606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLINE",
        "first_name": "ANGELA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "70111806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.