Active NPI
Mallory King
- Licensed Practical Nurse
- Portland, OR
National Provider Identifier
1366154569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 201130139LPN
- Practice address
- 8643 NE Beech St
Portland, OR 97220-5012 - Phone
- (503) 256-2151
- NPI assigned
- Dec 19, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 201130139LPN | OR | Primary |
Addresses
Primary practice location
8643 NE Beech St
Portland, OR 97220-5012
Mailing address
2380 19TH St
West Linn, OR 97068-4068
Phone (503) 250-3356
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mallory.king@outlook.com | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 201130139LPN | OR | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671408000000",
"number": "1366154569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2380 19TH ST",
"city": "WEST LINN",
"state": "OR",
"postal_code": "970684068",
"telephone_number": "503-250-3356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8643 NE BEECH ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972205012",
"telephone_number": "503-256-2151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "MALLORY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-19",
"last_updated": "2022-12-19",
"certification_date": "2022-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OR",
"license": "201130139LPN",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mallory.king@outlook.com",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Email",
"address_1": "8643 NE Beech St",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972205012",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.