Wendy Kay Kellam, PAC is a medicare enrolled "Physician Assistant" provider in Vancouver, Washington. Her current practice location is
2811 Ne 139th St, Vancouver, Washington. You can reach out to her office (for appointments etc.) via phone at
(360) 574-5247.
Wendy Kay Kellam is licensed to practice in Washington (license number PA60638000) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1083892665.
Healthcare Provider's Profile
| Full Name | Wendy Kay Kellam |
|---|
| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 2811 Ne 139th St, Vancouver, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1083892665
- Provider Enumeration Date: 02/05/2008
- Last Update Date: 10/14/2020
Medicare PECOS Information:
- PECOS PAC ID: 3577793439
- Enrollment ID: I20140220001764
Medical Identifiers
Medical identifiers for Wendy Kay Kellam such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1083892665 | NPI | - | NPPES |
| 1083892665 | Medicaid | WA | |
| 500663009 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 235Z00000X | Speech-language Pathologist | (* (Not Available)) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA164630 (Oregon) | Secondary |
| 363A00000X | Physician Assistant | PA60638000 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Wendy Kay Kellam is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Wendy Kay Kellam, PAC
Po Box 4825,
Portland, OR 97208-4825
Ph: (360) 882-2778 | Wendy Kay Kellam, PAC
2811 Ne 139th St,
Vancouver, WA 98686-2724
Ph: (360) 574-5247 |
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