Individual provider Active NPI

Kaeli Angeline Plaks

  • Counselor
  • Portland, OR
National Provider Identifier
1154833036
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
14600 NW Cornell Rd
Portland, OR 97229-5442
Phone
(503) 684-1424
NPI assigned
Oct 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

14600 NW Cornell Rd
Portland, OR 97229-5442

Mailing address

14600 NW Cornell Rd
Portland, OR 97229-5442

Other practice location 1

8770 SW Scoffins St
Tigard, OR 97223-6226
Phone (503) 684-1424

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

NPI Registry JSON

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1154833036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14600 NW CORNELL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14600 NW CORNELL RD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295442",
            "telephone_number": "503-684-1424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8770 SW Scoffins St",
            "address_purpose": "LOCATION",
            "city": "Tigard",
            "state": "OR",
            "postal_code": "972236226",
            "country_code": "US",
            "telephone_number": "503-684-1424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLAKS",
        "first_name": "KAELI",
        "middle_name": "ANGELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 1, 2021; 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.