Koali Anya Blumer-Buell, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

LC-LC-10220125 Issued in OR

Practice address

6355 N Haight Ave
Portland, OR 97217-2121

Phone

(503) 888-7346

NPI assigned

Mar 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1275280588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 N HAIGHT AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172121",
            "telephone_number": "503-888-7346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 N HAIGHT AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972172121",
            "telephone_number": "503-888-7346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUMER-BUELL",
        "first_name": "KOALI",
        "middle_name": "ANYA",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": "OR",
            "license": "LC-LC-10220125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON HEALTH LICENSING",
            "identifier": "LC-LC-10220125",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Jacqueline Blum, MSSW, LCSW
• Stephen Michael Blum, MD
• Blume Therapy LLC
• Daniel Logue Blumenthal
• Patricia Blumenthal, PSY.D.
• Kate Hanna Blumner, MD
• Blvd Centers, Inc
• Blyss Chiropractic
• Gretchen Karin Blyss, BA, DC
• Garrett James Boag

• Lactation Consultant (Non-RN) in Portland, OR
• Providers in Portland, OR by specialty
• Lactation Consultant (Non-RN) in Oregon

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