Healthcare Provider Details

I. General information

NPI: 1588577399
Provider Name (Legal Business Name): KIARA SOPHIA COBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11611 NE AINSWORTH CIR
PORTLAND OR
97220-9017
US

IV. Provider business mailing address

6670 SW 169TH AVE
BEAVERTON OR
97007-6385
US

V. Phone/Fax

Practice location:
  • Phone: 503-257-1732
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number10030118
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number10030118
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number10030118
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: