Individual provider Active NPI

Kalkidan Worku, ARNP

  • Family Nurse Practitioner
  • Lake Oswego, OR
National Provider Identifier
1992695886
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10037023 Issued in OR
Practice address
123 C Ave
Lake Oswego, OR 97034-2353
Phone
(541) 316-6575
NPI assigned
Jul 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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 10037023 OR Primary

Addresses

Primary practice location

123 C Ave
Lake Oswego, OR 97034-2353

Mailing address

PO Box 2430
The Dalles, OR 97058-8022
Phone (541) 316-6575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 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
I20250804003648 WA Practitioner - Nurse Practitioner 1153839881 Reassigns benefits to 1 organization
I20251202003261 OR Practitioner - Nurse Practitioner 1153839881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clear Choice DermatologyGroup PAC ID 4789005034, 47 clinicians

Practice addresses (Care Compare)

123 C Ave
Lake Oswego, OR 97034-2353
Phone (541) 316-6575

1815 Hudson St
Longview, WA 98632-2913
Phone (541) 316-6575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10037023ORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Choice Dermatology CurrentSince Aug 1, 2025 Accepting new patients

Locations

123 C Ave
Lake Oswego, OR 97034
Phone (702) 550-9784

37587 Highway 26
Sandy, OR 97055
Phone (503) 506-0474

1815 E 19th St
Ste B
The Dalles, OR 97058
Phone 5413166575184

310 S Roosevelt St
Goldendale, WA 98620
Phone (509) 486-2151

1815 Hudson St
Longview, WA 98632
Phone (360) 423-3399

Organizations & group practices 1

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": "1751500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1992695886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2430",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970588022",
            "telephone_number": "541-316-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 C AVE",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970342353",
            "telephone_number": "541-316-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORKU",
        "first_name": "KALKIDAN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-03",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10037023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.