Healthcare Provider Details

I. General information

NPI: 1750471025
Provider Name (Legal Business Name): LINDSAY KATE KLEPS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2006
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19250 SW 90TH AVE
TUALATIN OR
97062-7585
US

IV. Provider business mailing address

541 NE 20TH AVE STE 225
PORTLAND OR
97232-2895
US

V. Phone/Fax

Practice location:
  • Phone: 503-692-3750
  • Fax: 503-691-2324
Mailing address:
  • Phone: 503-963-2801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number200350106NP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: