Physician Assistant
KELLIE HERGENRADER
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1447911540 · enumerated 2022-01-01 · record updated 2024-04-16. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 915 SHERIDAN ST, PORT TOWNSEND, WA, 98368-2931 (360) 385-4848 Google Maps Apple Maps OpenStreetMap
- Mailing address 834 SHERIDAN ST, PORT TOWNSEND, WA, 98368-2443 (360) 385-2200 Google Maps Apple Maps OpenStreetMap
Specialties
- Student in an Organized Health Care Education/Training Program 390200000X
- Physician Assistant, Medical 363AM0700X
- Physician Assistant 363A00000X · Primary · License PA61479777 WA
In this directory
Locations and evidence
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Practice location
PORT TOWNSEND, WA, 983682931
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.