Active NPI
Patricia Esperanza Guardiola, LMT
- Specialist
- Portland, OR
National Provider Identifier
1134477375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 15397
- Practice address
- 13232 SE Stark St
Suite 3
Portland, OR 97233-1573 - Phone
- (503) 256-2654
- Fax
- (503) 256-2493
- NPI assigned
- Aug 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 15397 | OR | Primary |
Addresses
Primary practice location
13232 SE Stark St
Suite 3
Portland, OR 97233-1573
Mailing address
15758 SE Highway 224
Apt 1
Damascus, OR 97089-6417
Phone (503) 558-9197
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15397 | OR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1345420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345420800000",
"number": "1134477375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15758 SE HIGHWAY 224",
"address_2": "APT 1",
"city": "DAMASCUS",
"state": "OR",
"postal_code": "970896417",
"telephone_number": "503-558-9197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13232 SE STARK ST",
"address_2": "SUITE 3",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972331573",
"telephone_number": "503-256-2654",
"fax_number": "503-256-2493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUARDIOLA",
"first_name": "PATRICIA",
"middle_name": "ESPERANZA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-20",
"last_updated": "2012-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "15397",
"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 Aug 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.