Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenny Phu

Individual provider Physician Assistant · NPI 1497282289

Kenny Phu is a Physician Assistant in Portland, Oregon. Qualified in 2017, 9 years ago. Practices with Legacy Clinics LLC, a 718-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2017

Practice location Address checks out

501 N Graham St Ste 580
Portland, OR 97227-2003
Phone: (503) 528-0704
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3517 Ne 42nd Way, Vancouver, WA 98661-3171 — (360) 513-0469

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1497282289
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 11, 2017
Last updated in NPPESJuly 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Legacy Clinics Llc — 718 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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