Individual provider Active NPI

Kit B O'Boyle, RN, BSN, MSW, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1164908182
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L17485 Issued in OR
Practice address
4733 NE 104TH Ave
Portland, OR 97220-3347
Phone
(303) 990-2744
NPI assigned
Jul 12, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L17485 OR Primary
Case Management Registered Nurse 163WC0400X 201607356RN OR

Addresses

Primary practice location

4733 NE 104TH Ave
Portland, OR 97220-3347

Mailing address

4798 NE Going St
Portland, OR 97218-2002
Phone (303) 990-2744

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
L17485ORMDClinical Social Worker
201607356RNORMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1164908182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4798 NE GOING ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972182002",
            "telephone_number": "303-990-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4733 NE 104TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203347",
            "telephone_number": "303-990-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BOYLE",
        "first_name": "KIT",
        "middle_name": "B",
        "credential": "RN, BSN, MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L17485",
            "primary": true
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "OR",
            "license": "201607356RN",
            "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 May 11, 2026; 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.