NPIMap

Organization Active NPI

Mindful Kinetics LLC

  • Adult Mental Health Clinic/Center
  • Portland, OR
National Provider Identifier
1023879160
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
MINDFUL KINETICS LLC
Practice address
1210 SE Oak St Ste 6
Portland, OR 97214-1427
Phone
(503) 454-6481
NPI assigned
Jan 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nathan BeckerNPI 1679030969
Title
Owner
Phone
(503) 454-6481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1210 SE Oak St Ste 6
Portland, OR 97214-1427

Mailing address

1210 SE Oak St Ste 6
Portland, OR 97214-1427

National Provider Directory

National Provider Directory

Locations

1210 SE Oak St
Ste 6
Portland, OR 97214
Phone (503) 454-6481

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1023879160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 SE OAK ST STE 6",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 SE OAK ST STE 6",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141427",
            "telephone_number": "503-454-6481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINDFUL KINETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-454-6481"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.