Individual provider Active NPI

Kelley Ruth Ward, PA-C

  • Physician Assistant
  • Sandy, OR
National Provider Identifier
1225622293
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA213070 Issued in OR
Practice address
17055 Ruben LN
Sandy, OR 97055-9276
Phone
(503) 668-8002
NPI assigned
Feb 21, 2021
Last updated
Jul 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OR
Physician Assistant 363A00000X PA213070 OR Primary

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 1

  • Kelley Ruth Girouard Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, 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
I20230224000709 OR Practitioner - Physician Assistant 8426421389 Reassigns benefits to 3 organizations
I20250723003876 WA Practitioner - Physician Assistant 8426421389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
96.73

Merit-based Incentive Payment System (MIPS)

Final score
92 of 100Reported as group
Quality
84.7
Promoting interoperability
100
Improvement activities
40
Cost
79.21

Merit-based Incentive Payment System (MIPS)

Final score
96.85 of 100Reported as group
Quality
84.92
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Nov 22, 2022 Accepting new patients
Northwest Acute Care Specialists PC CurrentSince Mar 4, 2024 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jul 9, 2025 Accepting new patients
Legacy Clinics LLC CurrentSince Jul 9, 2025 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

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

19250 SW 65th Ave
Ste 260
Tualatin, OR 97062
Phone (503) 352-0770

19300 SW 65th Ave
Tualatin, OR 97062
Phone (503) 692-1212

2121 NE 139th St
Ste 245
Vancouver, WA 98686
Phone (360) 326-3966

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1613865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1225622293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17055 RUBEN LN",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970559276",
            "telephone_number": "503-668-8002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2730 S Moody Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972015042",
            "country_code": "US",
            "telephone_number": "503-494-3633",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19250 SW 65th Ave Ste 260",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "97062",
            "country_code": "US",
            "telephone_number": "503-413-5525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARD",
        "first_name": "KELLEY",
        "middle_name": "RUTH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-21",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA213070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLEY",
            "last_name": "GIROUARD",
            "middle_name": "RUTH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sandy, OR

Sources for this page

Verify at the official NPI Registry.