Medipro Direct Slim, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MEDIPRO DIRECT SLIM, LLC

Practice address

17933 NW Evergreen Pkwy
Suite 220
Beaverton, OR 97006-7659

Phone

(503) 828-9265

Fax

(503) 828-9054

NPI assigned

Mar 15, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Kelly Kyser

Title

Office Manager

Phone

(503) 828-9265

Specialties & licenses 10

Addresses

Other names 1

• MediPro Holistic Health Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hilary Sandell, ND, LAC

  • Naturopath
  • Beaverton, OR
  • NPI 1912397308

  Acupuncturist

  NPD (past)

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

{
    "created_epoch": "1363305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1457692444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17933 NW EVERGREEN PKWY STE 285",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067513",
            "telephone_number": "503-828-9265",
            "fax_number": "503-303-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17933 NW EVERGREEN PKWY",
            "address_2": "SUITE 220",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067659",
            "telephone_number": "503-828-9265",
            "fax_number": "503-828-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIPRO DIRECT SLIM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-15",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "KYSER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "503-828-9265",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": "OR",
            "license": "1430",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Naturopath",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MediPro Holistic Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Suzanne McReynolds
• Alyson Meadows, NBC-HWC
• Jennifer Dale Means, ND, LAC
• Seth Means, D.C.
• Medical Interventions for Neuroplastic Development Hub. LLC
• Stacy Medof, THW, PSS, PWS
• Diane Elizabeth Meehan, RDN, LD
• Laura Hart Meeker, MD
• Smadar Megnazi, LPC
• Zahra Mehdizadeh Kashi, PHD

• Multi-Specialty Clinic/Center in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Multi-Specialty Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.

Verify at the official NPI Registry.