KARLY GLENN
NPI 1679255004
Physician Assistant - Medical in Lake Oswego, OR
About Karly Glenn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KARLY GLENN (NPI 1679255004) is an individual medical provider in Lake Oswego, Oregon, licensed in Oregon (PA222423) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS, is affiliated with Willamette Valley Medical Center, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Karly Glenn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Willamette Valley Medical Center
Acute Care Hospitals · Mcminnville, OROther Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
LAKE OSWEGO, OR 97035
LAKE OSWEGO, OR 97035
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Karly Glenn's NPI number?
The NPI number for Karly Glenn is 1679255004. It was assigned to this individual provider in the NPPES registry on August 4, 2023.
Where is Karly Glenn located?
Karly Glenn practices at 16463 Boones Ferry Rd Ste 300, Lake Oswego, OR 97035. The listed phone number is (503) 658-9351.
What is Karly Glenn's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.
Is Karly Glenn enrolled in Medicare?
Yes. Karly Glenn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Karly Glenn affiliated with any hospitals?
According to CMS data, Karly Glenn is affiliated with Willamette Valley Medical Center.
When was this NPI record last updated?
The NPPES record for Karly Glenn was last updated on December 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Karly Glenn · NPI 1679255004
Medical physician in Lake Oswego, Oregon. Individual provider, active in the CMS NPPES registry since August 4, 2023.
## Identity
- **NPI:** 1679255004 (Entity type: Individual)
- **Enumerated:** August 4, 2023
- **Primary specialty:** Physician Assistant - Medical · taxonomy 363AM0700X
- **State license:** PA222423 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 16463 BOONES FERRY RD STE 300, Lake Oswego, OR 97035-4376
- **Phone:** (503) 658-9351
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** December 10, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1679255004) · Data from the CMS NPPES public registry.