Look up the most recent NPI and PECOS records

Kendra D Mesa

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3181 SW Sam Jackson Park Rd # Ed, Portland, OR 97239-3011

PECOS Enrollment

This provider is enrolled in PECOS as KENDRA MESA.

Based on the most recent information from CMS, provider Kendra D Mesa is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1164830212
Provider Type
Individual
Full Name
Mesa, Kendra D
Title
Mrs.
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
7/31/2014
Last Updated
4/26/2022

Contact Information

Practice Location

3181 SW Sam Jackson Park Rd # Ed, Portland, OR 97239-3011

(503) 494-7551

(503) 494-4997

Mailing Location

60 S 11th Ct, Ridgefield, WA 98642-9386

(239) 218-6724

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA209206 Oregon
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA60493784 Washington

Kendra D Mesa

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Liu, Zhongfeng

Melean, Cynthia Elizabeth

Rowden, Daniel

Shears, Gayle Lauren

Skolnik, Kevin

Myers, Robert A

Kelly, Nicole

Rogers, Samuel

Keranen, Katharine J

Fillman, Reid Wilder