NPIMap

Organization Active NPI

Healthbridge Inc

  • Naturopath
  • Portland, OR
National Provider Identifier
1184786543
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
1385 Issued in OR
Legal business name
HEALTHBRIDGE INC
Practice address
3046 NE 33Rd Ave
Portland, OR 97212-3654
Phone
(503) 331-7393
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Authorized official

Name
Dr. Robert B Kellum, N.D., L.AC.
Title
President
Phone
(503) 331-7393

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X AC00840 OR
NaturopathGroup: 193200000X MULTI-SPECIALTY GROUP 175F00000X 1385 OR Primary

Addresses

Primary practice location

3046 NE 33Rd Ave
Portland, OR 97212-3654

Mailing address

3046 NE 33Rd Ave
Portland, OR 97212-3654
Phone (503) 331-7393

Other identifiers 3

IdentifierTypeStateIssuer
AC00840OtherORACUPUNCTURE LICENSE
7277OtherORMASSAGE LICENSE
1385OtherORNATUROPATHIC LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1184786543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3046 NE 33RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123654",
            "telephone_number": "503-331-7393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3046 NE 33RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123654",
            "telephone_number": "503-331-7393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHBRIDGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "KELLUM",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-331-7393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "N.D., L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC00840",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE LICENSE",
            "identifier": "AC00840",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE LICENSE",
            "identifier": "7277",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATUROPATHIC LICENSE",
            "identifier": "1385",
            "state": "OR"
        }
    ],
    "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 Apr 11, 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.

Verify at the official NPI Registry.