Kelley Ruth Ward, PA-C
Individual provider Active NPI Physician Assistant · Sandy, OR
NPI 1225622293 · NPPES record last updated Jul 9, 2025
Key facts
- NPI
- 1225622293
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA213070 (OR)
- Practice address
- 17055 Ruben LN
Sandy, OR 97055-9276 - Phone
- (503) 668-8002
- NPI assigned
- Feb 21, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Legacy Clinics LLC
Practice addresses (Care Compare)
1130 NW 22ND Ave
Suite 220
Portland, OR 97210-2969
Phone (503) 413-8988
19250 SW 65TH Ave
Suite 265
Tualatin, OR 97062-7747
Phone (503) 413-6862
19300 SW 65TH Ave
Meridian Park Hosp
Portland, OR 97062-7706
Phone (503) 692-1212
24800 SE Stark St
Gresham, OR 97030-3378
Phone (503) 413-8988
25050 SE Stark St
Gresham, OR 97030-3383
Phone (503) 674-1848
Hospital & facility affiliations
- Legacy Meridian Park Medical Center
- Legacy Mount Hood Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 96.73
Merit-based Incentive Payment System (MIPS)
- Final score
- 92 of 100
- Quality
- 84.7
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 79.21
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.85 of 100
- Quality
- 84.92
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in OR, WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230224000709 | OR | Practitioner - Physician Assistant | 8426421389 | Reassigns benefits to 3 organizations |
| I20250723003876 | WA | Practitioner - Physician Assistant | 8426421389 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA213070 | OR | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Salmon Creek Hospital | Current |
Accepting new patients | |
| Providence Health & Services - Oregon | Current |
Accepting new patients | |
| Northwest Acute Care Specialists PC | Current |
Accepting new patients | |
| Legacy Clinics LLC | Current |
Accepting new patients | |
| Legacy Salmon Creek Hospital | Current |
Accepting new patients |
Locations
2725 SW Cedar Hills Blvd
Ste 250
Beaverton, OR 97005
Phone (503) 413-4060
24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407
25050 SE Stark St
Gresham, OR 97030
Phone (503) 413-5702
1001 N Providence Dr
Newberg, OR 97132
Phone (503) 216-1538
1015 NW 22nd Ave
Portland, OR 97210
Phone (503) 413-7582
2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600
19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212
19250 SW 65th Ave
Ste 260
Tualatin, OR 97062
Phone (503) 352-0770
2121 NE 139th St
Ste 245
Vancouver, WA 98686
Phone (360) 326-3966
2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | OR | ||
| Physician Assistant | 363A00000X | PA213070 | OR | Yes |
Addresses
Primary practice location
17055 Ruben LN
Sandy, OR 97055-9276
Mailing address
PO Box 3777
Portland, OR 97208-3777
Other practice location 1
2730 S Moody Ave
Portland, OR 97201-5042
Phone (503) 494-3633
Other practice location 2
19250 SW 65th Ave Ste 260
Tualatin, OR 97062
Phone (503) 413-5525
Other names
- Kelley Ruth Girouard
Other providers in Sandy, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.