NPIMap

Individual provider Active NPI

Katherine Anne Liebler, PA-C

  • Physician Assistant
  • Medford, OR
National Provider Identifier
1750426912
Registry record updated Aug 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA160584 Issued in OR
Practice address
70 Bower Dr
Medford, OR 97501-3688
Phone
(541) 732-8300
NPI assigned
Feb 21, 2007
Last updated
Aug 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA160584 OR Primary

Addresses

Primary practice location

70 Bower Dr
Medford, OR 97501-3688

Mailing address

PO Box 31001
Pasadena, CA 91110-4180
Phone (541) 732-8300

Other identifiers 1

IdentifierTypeStateIssuer
500623080MedicaidOR

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kliebler269822@oc.providencedirect.org
Direct Messaging Address kliebler269822@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130708000802 OR Practitioner - Physician Assistant 6800992314 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

940 Royal Ave
Medford, OR 97504-6194

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18752CAMDAcupuncturist
PA18752CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon CurrentSince Feb 20, 2025 Accepting new patients
Providence Health & Services - Oregon CurrentSince Feb 20, 2025 Accepting new patients

Locations

1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250

940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460

Organizations & group practices 4

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 3

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1750426912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104180",
            "telephone_number": "541-732-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BOWER DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013688",
            "telephone_number": "541-732-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBLER",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA160584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500623080",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kliebler269822@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1321 NE 99th Ave Ste 100",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972209437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kliebler269822@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1321 NE 99TH AVE",
            "address_2": "SUITE 200",
            "city": "PORTLAND",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972209439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

Verify at the official NPI Registry.