Individual provider Active NPI

Kimberly Ann Sieffert, CADC II

  • Addiction (Substance Use Disorder) Counselor
  • Milwaukie, OR
National Provider Identifier
1316203086
Registry record updated Apr 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
11-R-17 Issued in OR
Practice address
17882 SE McLoughlin Blvd
Milwaukie, OR 97267-6103
Phone
(503) 353-9409
NPI assigned
Apr 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11-R-17 OR Primary

Addresses

Primary practice location

17882 SE McLoughlin Blvd
Milwaukie, OR 97267-6103

Mailing address

211 SE 143Rd Ave
Portland, OR 97233-2115
Phone (503) 894-2880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11-R-17ORMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1333756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333756800000",
    "number": "1316203086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 SE 143RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972332115",
            "telephone_number": "503-894-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17882 SE MCLOUGHLIN BLVD",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972676103",
            "telephone_number": "503-353-9409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEFFERT",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CADC II",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-07",
        "last_updated": "2012-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "11-R-17",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2012; 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.