Individual provider · Type 1 NPI

Katherine Kelly Fossetta, PHYSICIAN ASSISTANT

Physician Assistant · Portland, OR

NPI number 1013758911 Active

Practice location

2730 S Moody Ave
Portland, OR 97201-5042

Call (503) 494-9645 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Physician Assistant Primary 363A00000X70064047 (WA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1013758911

Katherine Kelly Fossetta, PHYSICIAN ASSISTANT's National Provider Identifier is 1013758911, issued on Jun 4, 2024. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Portland, OR. The record was last updated on Oct 12, 2026.