Kimberly Nicole Peterson, M.A.

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

1500 NE Irving St
Suite 250
Portland, OR 97232-2243

Phone

(503) 233-4356

NPI assigned

Mar 7, 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

Other names 1

• Kimberly Nicole Redslob Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316078967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 NE 48TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972182053",
            "telephone_number": "503-307-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 NE IRVING ST",
            "address_2": "SUITE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322243",
            "telephone_number": "503-233-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "REDSLOB",
            "middle_name": "NICOLE",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie M. Peterson, PMHNP
• Kathryn Peterson
• Katlyn Rene Peterson, OD
• Katy Celeste Peterson
• Kay Diane Peterson, PMHNP
• Leah Peterson, CNM
• Lindsey Louise Peterson, PA-C
• Lucy Rose Peterson, CADC II, QMHA-R
• Matthew Peterson
• Megan Peterson

• Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.