Individual provider Active NPI

Kimberly Anne Kumiko Portch, PA-C

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1164058277
Registry record updated Sep 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61077701 Issued in WA
Practice address
212 E Central Ave Ste 335
Spokane, WA 99208-6289
Phone
(509) 482-2232
NPI assigned
Mar 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 61077701 WA Primary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA-1969 ID

Addresses

Primary practice location

212 E Central Ave Ste 335
Spokane, WA 99208-6289

Mailing address

PO Box 31001-4114
Pasadena, CA 91110-0001
Phone (866) 747-2455

Other practice location 1

13424 E Mission Ave
Spokane Valley, WA 99216-2759
Phone (509) 822-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201124002210 ID Practitioner - Physician Assistant 6709297641 Reassigns benefits to 1 organization
I20211007002744 WA Practitioner - Physician Assistant 6709297641 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
R Franklin University of Med & Sci/Chicago Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Oncology Associates PSGroup PAC ID 6901890243, 10 clinicians

Practice addresses (Care Compare)

13424 E Mission Ave
Spokane Valley, WA 99216-2759
Phone (509) 462-2273

143 Garden Homes Dr
Colville, WA 99114-9229
Phone (509) 462-2273

6001 N Mayfair St
Spokane, WA 99208-1129
Phone (509) 462-2273

Hospital & facility affiliations

  • Providence Mount Carmel Hospital Hospital, Colville, WA, CCN 501326
  • Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054
  • Newport Community Hospital Hospital, Newport, WA, CCN 501310

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-1969IDMDPhysician Assistant
61077701WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Oncology Associates, PS Single Specialty CurrentSince Jul 1, 2025 Accepting new patients
Multicare Health System CurrentSince Nov 20, 2023 Accepting new patients
Multicare Health System CurrentSince Nov 20, 2023 Accepting new patients

Locations

414 Church St
Ste 306
Sandpoint, ID 83864
Phone (208) 618-5212

143 Garden Homes Dr
Colville, WA 99114
Phone (509) 684-3701

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

6001 N Mayfair St
Spokane, WA 99208
Phone (509) 455-9550

Organizations & group practices 6

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

Hospital & facility affiliations 3

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": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788480000000",
    "number": "1164058277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-4114",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911100001",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 E CENTRAL AVE STE 335",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086289",
            "telephone_number": "509-482-2232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13424 E Mission Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992162759",
            "country_code": "US",
            "telephone_number": "509-822-4200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTCH",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE KUMIKO",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "61077701",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1969",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.