Kellyn Adams – Naturopath in Portland, OR

Key facts

NPI: 1114398690
Entity type: Individual (NPI type 1)
Primary specialty: Naturopath 175F00000X
License: 3024 (OR)
Practice address: 2330 NW Flanders St
Suite 101
Portland, OR 97210
Phone: (503) 701-8766
Fax: (503) 241-5484
NPI assigned: Oct 9, 2015
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
3024	OR	MD	Naturopath

Interoperability endpoints

Direct secure messaging: kellyn.adams.1@29632.direct.athenahealth.com

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Naturopath	175F00000X	3024	OR	Yes

Addresses

Primary practice location

2330 NW Flanders St
Suite 101
Portland, OR 97210

Mailing address

2330 NW Flanders St
Suite 101
Portland, OR 97210
Phone (503) 701-8766

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 9, 2015.

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444348800000",
    "number": "1114398690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 NW FLANDERS ST",
            "address_2": "SUITE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-701-8766",
            "fax_number": "503-241-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 NW FLANDERS ST",
            "address_2": "SUITE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97210",
            "telephone_number": "503-701-8766",
            "fax_number": "503-241-5484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "KELLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2015-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "3024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

All providers in Portland, OR · Naturopath in Oregon

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.