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NPI Code Detail

MEDICARE: ADAM KINNARD NP, RN

MEDICARE: ADAM KINNARD NP, RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse202111102RNOR
2363LP0808XPsychiatric/Mental Health Nurse Practitioner10049497OR

General Provider Information

NPI Number : 1710756226
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM KINNARD NP, RN
Provider Business Mailing Address
First Line : 232 NW 6TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97209-3609
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12121 E BURNSIDE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97216-3737
Country : US
Telephone Number : 971-361-7700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2023
Last Update Date : 06/17/2026

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