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General NPI Number Information
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NPI Number | 1841930377
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Entity Type | Individual
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Provider Name | JAIME L KLEIN RN/QMHP
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Gender | Female
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 620 NE 2ND ST
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City | GRESHAM
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State | OR
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Zip | 97030-7514
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Country | US
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Telephone | 971-274-3757
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Fax | 503-912-5740
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Provider Business Mailing Address
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Address Line | 1776 SW MADISON ST
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City | PORTLAND
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State | OR
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Zip | 97205-1715
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Country | US
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Telephone | 503-224-1044
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Fax | 503-621-2235
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN61265472
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 244249-30
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041475816
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN.1676881
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License Number State | CO
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Taxonomy #6
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 202108657RN
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License Number State | OR
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