Individual provider Active NPI

Dorian Ariel Zeidenweber

  • Student in an Organized Health Care Education/Training Program
  • Portland, OR
National Provider Identifier
1386204980
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1040 NW 22ND Ave
Portland, OR 97210-3057
Phone
(619) 319-7088
NPI assigned
Jun 17, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1040 NW 22ND Ave
Portland, OR 97210-3057

Mailing address

3536 NE 168TH St Apt 205
N Miami Beach, FL 33160-3507

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

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1386204980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3536 NE 168TH ST APT 205",
            "city": "N MIAMI BEACH",
            "state": "FL",
            "postal_code": "331603507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 NW 22ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972103057",
            "telephone_number": "619-319-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEIDENWEBER",
        "first_name": "DORIAN",
        "middle_name": "ARIEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 17, 2019; 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.