Huckleberry TM Koester, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

013240 Issued in OR

Practice address

745 NE 122ND Ave
Portland, OR 97230-2001

Phone

(503) 252-0241

NPI assigned

Apr 16, 2013

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

Other names 1

• Huckleberry TM Keyes Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1295178606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE",
            "address_2": "SUITE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 NE 122ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972302001",
            "telephone_number": "503-252-0241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOESTER",
        "first_name": "HUCKLEBERRY",
        "middle_name": "TM",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "013240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HUCKLEBERRY",
            "last_name": "KEYES",
            "middle_name": "TM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Koerner
• Tess Kathryn Koerner, AUD, PHD, CCC-A
• Richard Koesel, MD
• Amanda Koester
• G Koester, CD(DONA)
• Yilun Koethe, M.D.
• Bettylou Koffel, MD
• Kofoed Enteprises PC
• Jeffrey Lee Koh, M.D.
• Joon Koh, DMD

• Speech-Language Pathologist in Portland, OR
• Providers in Portland, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; 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.