Healthcare Provider Details

I. General information

NPI: 1386897809
Provider Name (Legal Business Name): MARIA S KLING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2008
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 NW COUNCIL DR SUITE 101
GRESHAM OR
97030-3721
US

IV. Provider business mailing address

PO BOX 92900
PORTLAND OR
97292-0900
US

V. Phone/Fax

Practice location:
  • Phone: 503-665-8176
  • Fax: 503-665-8178
Mailing address:
  • Phone: 503-665-8176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number201393371NP-PP
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number18610
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: