Kathleen Marie Palm, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD19206 Issued in OR

Practice address

15950 SW Millikan Way
Beaverton, OR 97006

Phone

(503) 646-0161

Fax

(503) 643-7459

NPI assigned

Sep 28, 2006

Last updated

Nov 17, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: kpalm1758@direct.theportlandclinic.net

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.

• Portland Clinic

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1558379099
  Medicare reassignment

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1659463743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051902",
            "telephone_number": "503-221-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15950 SW MILLIKAN WAY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97006",
            "telephone_number": "503-646-0161",
            "fax_number": "503-643-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALM",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD19206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071693",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpalm1758@direct.theportlandclinic.net",
            "affiliation": "N",
            "address_1": "15950 SW Millikan Way",
            "city": "Beaverton",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Helen Pak, DC
• Kaitlyn Nicole Palau
• Yolonda Palen, LMT
• Michael Palensky, M.A., FAAA
• Elizabeth Palestino, CSWA, MSW
• Devon J Palmanteer, LMFT
• Robin Aurora Palmer-Nicks, DC
• Alicia J. Palmer
• Angela Kalene Palmer, N.D.
• Jennifer Marie Palmer

• Pediatrics Physician in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.