Kenneth George Lie, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD24371 Issued in OR

Practice address

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970

Phone

(503) 652-2880

NPI assigned

Aug 29, 2006

Last updated

May 4, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Anesthesiology

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Oregon Anesthesiology Group PCGroup PAC ID 3476451659, 239 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klie477763@direct.peacehealth.org

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.

• Oregon Anesthesiology Group PC

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1477527786

  WA

  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of Washington - TCS

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1649816380
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  Anesthesiology

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

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

• Legacy Salmon Creek Hospital

  dba Legacy Salmon Creek Providers

  • Clinic/Center
  • Vancouver, WA
  • NPI 1356357784

  Hospital

  Care Compare affiliation
• Legacy Salmon Creek Hospital

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1700809829
  Care Compare affiliation

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620086400000",
    "number": "1538277595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13845 SE MOUNTAIN CREST DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "970866751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970",
            "telephone_number": "503-652-2880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1615 Delaware St",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "98632",
            "country_code": "US",
            "telephone_number": "360-636-4878",
            "fax_number": "360-414-7638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIE",
        "first_name": "KENNETH",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD24371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lin Juan Li, PA-C
• Azeb Libase, RN
• Marcia Liberson
• Licensed Psychology Associates LLC
• Michael Todd Lichtenberg, M.A., MCFT, QMHP
• Stephen Farrell Lieberman, M.D.
• Jeffrey Stephen Liebo, M.D.
• Allegra Liedtke, MS
• Jeffrey James Lillie, PHARM D
• Claudio Rogerio Lima, P.A.

• Anesthesiology Physician in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Anesthesiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.