=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881728087
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KINSHIP HOUSE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/16/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1823 NE 8TH AVE
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97212-3907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-460-2796
-----------------------------------------------------
Fax | 503-460-3750
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1823 NE 8TH AVE
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97212-3907
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-460-2796
-----------------------------------------------------
Fax | 503-460-3750
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. BETHEL MAY LEVAD
-----------------------------------------------------
Credential | B.S.
-----------------------------------------------------
Telephone | 503-460-2796
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------