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1932510682 NPI number — KB LLC DBA SENIOR HELPERS OF PORTLAND

NPI Number: 1932510682
Health Care Provider/Practitioner: KB LLC DBA SENIOR HELPERS OF PORTLAND

Information about “1932510682” NPI (KB LLC DBA SENIOR HELPERS OF PORTLAND) exists in 1932510682 in HTML format HTML  |  1932510682 in plain Text format TXT  |  1932510682 in PDF (Portable Document Format) PDF  |  1932510682 in an XML format XML  formats.

NPI Number : 1932510682 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1932510682",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "KB LLC DBA SENIOR HELPERS OF PORTLAND",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "25 NW 23RD PL STE 6",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PORTLAND",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97210-5580",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "503-892-1189",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "407 NW 17TH AVE STE 16",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PORTLAND",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97209-2249",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "503-892-1189",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/15/2014",
    "LastUpdateDate": "05/15/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BRADLEY",
    "AuthorizedOfficialFirstName": "KELLI",
    "AuthorizedOfficialMiddleName": "ANN",
    "AuthorizedOfficialTitle": "OWNER/ADMINISTRATOR",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "503-381-9194",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "253Z00000X",
        "TaxonomyName": "In Home Supportive Care Agency",
        "LicenseNumber": "15-2171",
        "LicenseNumberStateCode": "OR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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