NW Ketamine Infusion LLC

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

Legal business name

NW KETAMINE INFUSION LLC

Practice address

19365 SW 65TH Ave Ste 205
Tualatin, OR 97062-9196

Phone

(503) 427-0356

Fax

(503) 907-9255

NPI assigned

Jul 12, 2022

Organization subpart

No

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

Authorized official

Name

Mr. David Kleiman, CRNANPI 1013399518

Title

Owner

Phone

(323) 687-6775

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Kleiman, CRNA

  • Certified Registered Nurse Anesthetist
  • Houston, TX
  • NPI 1013399518

  Nurse Anesthetist, Certified Registered

  NPD Authorized official

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

{
    "created_epoch": "1657584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1255065504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19365 SW 65TH AVE STE 205",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629196",
            "telephone_number": "503-427-0356",
            "fax_number": "503-907-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19365 SW 65TH AVE STE 205",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970629196",
            "telephone_number": "503-427-0356",
            "fax_number": "503-907-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NW KETAMINE INFUSION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-12",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A",
        "authorized_official_last_name": "KLEIMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "323-687-6775",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Internal Medicine LLC
• Northwest Medical Staffing, LLC
• Northwest Neurosurgical Associates,LLC
• Northwest Renal Clinic, Inc.
• Nurturing Minds LLC
• NW Physical Therapy Specialists
• Occupational Orthopedics LLC
• Warren Ikpomosa Okuns, M.D.
• Andrea C Olmstead, MD
• Kassandra Olsen, PTA, LMT

• Certified Registered Nurse Anesthetist in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Certified Registered Nurse Anesthetist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.