Individual provider Active NPI

Kathryn E Ayers, MSW

  • Clinical Social Worker
  • Beaverton, OR
National Provider Identifier
1194744656
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4021 Issued in OR
Practice address
14195 SW Millikan Way
Beaverton, OR 97005-2307
Phone
(503) 646-5687
Fax
(503) 644-0379
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X L4021 OR Primary

Addresses

Primary practice location

14195 SW Millikan Way
Beaverton, OR 97005-2307

Mailing address

21000 NW Quatama Rd
Unit 200
Beaverton, OR 97006-1410
Phone (503) 430-8136

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
L4021ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1194744656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 NW QUATAMA RD",
            "address_2": "UNIT 200",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970061410",
            "telephone_number": "503-430-8136",
            "fax_number": "503-644-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14195 SW MILLIKAN WAY",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970052307",
            "telephone_number": "503-646-5687",
            "fax_number": "503-644-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYERS",
        "first_name": "KATHRYN",
        "middle_name": "E",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.