Individual provider Active NPI

Katia Lease Shorb, FNP

  • Nurse Practitioner
  • Portland, OR
National Provider Identifier
1336289974
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
200550120NP Issued in OR
Practice address
619 NW 6TH Ave FL 2
Portland, OR 97209-3964
Phone
(503) 988-3700
NPI assigned
Feb 6, 2007
Last updated
Nov 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 200550120NP OR Primary

Addresses

Primary practice location

619 NW 6TH Ave FL 2
Portland, OR 97209-3964

Mailing address

619 NW 6TH Ave FL 5
Portland, OR 97209-3964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090213000470 OR Practitioner - Nurse Practitioner 2961567540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multnomah CountyGroup PAC ID 6608771787, 111 clinicians

Practice addresses (Care Compare)

600 NE 8TH St
Gresham, OR 97030-7317
Phone (503) 988-7468

619 NW 6TH Ave
Portland, OR 97209-3964
Phone (503) 988-7468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200550120NPORMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Jul 11, 2010 Accepting new patients
Multnomah County Current Accepting new patients
Multnomah County CurrentSince Jul 11, 2010 Accepting new patients
Multnomah County PastSince Dec 1, 2019 Accepting new patients

Locations

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Fl 2
Portland, OR 97209
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-5558

Interoperability endpoints

  • Direct secure messaging: kshorb138357@direct.ochin.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1336289974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 5",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 NW 6TH AVE FL 2",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972093964",
            "telephone_number": "503-988-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORB",
        "first_name": "KATIA",
        "middle_name": "LEASE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "200550120NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.