Active NPI
Kaiser Permanente
- Health Maintenance Organization
- Portland, OR
National Provider Identifier
1306270228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Maintenance Organization
- License
- LCSW5754
- Legal business name
- KAISER PERMANENTE
- Practice address
- 3550 N Interstate Ave
Portland, OR 97227-1196 - Phone
- (503) 249-5276
- NPI assigned
- Aug 27, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Maria Georgina Gonzalez-Leon, LCSW
- Title
- LCSW
- Phone
- (503) 308-0524
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Maintenance Organization | 302R00000X | LCSW5754 | OR | Primary |
Addresses
Primary practice location
3550 N Interstate Ave
Portland, OR 97227-1196
Mailing address
608 SE 112TH Ave
Portland, OR 97216-3414
Phone (503) 308-0524
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5754 | Other | OR | LCSW |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1377561600000",
"number": "1306270228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "608 SE 112TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972163414",
"telephone_number": "503-308-0524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3550 N INTERSTATE AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271196",
"telephone_number": "503-249-5276"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KAISER PERMANENTE",
"organizational_subpart": "NO",
"enumeration_date": "2013-08-27",
"last_updated": "2013-08-27",
"status": "A",
"authorized_official_last_name": "GONZALEZ-LEON",
"authorized_official_first_name": "MARIA",
"authorized_official_middle_name": "GEORGINA",
"authorized_official_title_or_position": "LCSW",
"authorized_official_telephone_number": "503-308-0524",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "302R00000X",
"taxonomy_group": "",
"desc": "Health Maintenance Organization",
"state": "OR",
"license": "LCSW5754",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "5754",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.