Individual provider Active NPI

Karen Anne McClish, MSN, FNP

  • Family Nurse Practitioner
  • Tualatin, OR
National Provider Identifier
1851364350
Registry record updated Aug 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200550109 Issued in OR
Practice address
19185 SW 90TH Ave
Tualatin, OR 97062-7558
Phone
(503) 813-2000
NPI assigned
Feb 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200550109 OR Primary

Addresses

Primary practice location

19185 SW 90TH Ave
Tualatin, OR 97062-7558

Mailing address

19185 SW 90TH Ave
Tualatin, OR 97062-7558
Phone (503) 813-2000

Other identifiers 1

IdentifierTypeStateIssuer
270149MedicaidOR

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
I20051013000983 OR Practitioner - Nurse Practitioner 0749205185 Reassigns benefits to 1 organization
I20191018001487 WA Practitioner - Nurse Practitioner 0749205185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

19185 SW 90TH Ave
Tualatin, OR 97062-7558
Phone (800) 813-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200550109ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jul 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Current Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

19185 SW 90th Ave
Tualatin, OR 97062
Phone (503) 723-6699

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1851364350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19185 SW 90TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627558",
            "telephone_number": "503-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19185 SW 90TH AVE",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970627558",
            "telephone_number": "503-813-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLISH",
        "first_name": "KAREN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200550109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270149",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

Verify at the official NPI Registry.