Kimberly Fanning

Primary specialty

Adult CompanionTaxonomy code 372600000X

Practice address

3034 NE MLK
Portland, OR 97212-3053

Phone

(503) 889-2523

NPI assigned

Nov 12, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194825600000",
    "number": "1265612808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3034 NE MLK",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972123053",
            "telephone_number": "503-889-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNING",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Fanning
• Cate Fanning
• Chandler Lori Fanning
• Deborah Fanning, CPNP
• Jeanette Marie Fanning, QMHA
• Sydney Hanna Fanning, PMHNP
• Fanno Creek Clinic LLC
• Erin Fanshier, MSW
• Edlawet G Fanta
• Hawi Fantaye, RN, BSN

• All providers in Portland, OR
• Adult Companion in Oregon

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