Individual provider Active NPI

Michela Kenning, O.D.

  • Optometrist
  • Beaverton, OR
National Provider Identifier
1558624320
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3446ATI Issued in OR
Practice address
672 NW Autumncreek Way Apt M303
Beaverton, OR 97006-7789
Phone
(314) 304-7484
NPI assigned
Jun 18, 2012
Last updated
Aug 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD.OD.60280003 WA
Optometrist 152W00000X 3446ATI OR Primary
Optometrist 152W00000X 139664 IA
Optometrist 152W00000X 4078 MN
Optometrist 152W00000X OPT-002978 AZ

Addresses

Primary practice location

672 NW Autumncreek Way Apt M303
Beaverton, OR 97006-7789

Mailing address

1704 SE 170TH Ave
Vancouver, WA 98683-3445
Phone (314) 304-7484

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150917002112 OR Practitioner - Optometry 3971739178 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3446ATIORMDOptometrist
3466ATIORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific University Optometrist CurrentSince Jul 1, 2015 Accepting new patients
Pacific University Optometrist Current Accepting new patients
Pacific University CurrentSince Jul 1, 2015 Accepting new patients
Innervision Optometric Inc. Optometrist CurrentSince Jun 20, 2016 Accepting new patients
Pacific University Optometrist Past Accepting new patients
Pacific University Optometrist Past Accepting new patients

Locations

2043 College Way
Forest Grove, OR 97116
Phone (503) 352-2020

222 SE 8th Ave
#212
Hillsboro, OR 97123
Phone 5033522400 ext. 8060

222 SE 8th Ave
Ste 114
Hillsboro, OR 97123
Phone (503) 352-7300

1411 SW Morrison St
Ste 310
Portland, OR 97205

8269 SW Wilsonville Rd
Ste G
Wilsonville, OR 97070
Phone (503) 685-9015

Interoperability endpoints

  • FHIR API: https://eyetoeyewilsonville.ef.prod.fhir.ema-api.com/fhir/r4/
  • Direct secure messaging: mkenning315793@direct.ochin.org

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1558624320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 SE 170TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833445",
            "telephone_number": "314-304-7484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "672 NW AUTUMNCREEK WAY APT M303",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067789",
            "telephone_number": "314-304-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNING",
        "first_name": "MICHELA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-18",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD.OD.60280003",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3446ATI",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "139664",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "4078",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "OPT-002978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

Verify at the official NPI Registry.