Individual provider Active NPI

Kenneth B. Lease, NP

  • Adult Health Nurse Practitioner
  • Hillsboro, OR
National Provider Identifier
1487750709
Registry record updated Jul 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
OR 079043505N3 Issued in OR
Practice address
19400 NW Evergreen Pkwy
Hillsboro, OR 97124-7031
Phone
(503) 645-2762
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X OR 079043505N3 OR Primary

Addresses

Primary practice location

19400 NW Evergreen Pkwy
Hillsboro, OR 97124-7031

Mailing address

19400 NW Evergreen Pkwy
Hillsboro, OR 97124-7031

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
OR 079043505N3ORMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184457600000",
    "number": "1487750709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19400 NW EVERGREEN PKWY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971247031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19400 NW EVERGREEN PKWY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971247031",
            "telephone_number": "503-645-2762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEASE",
        "first_name": "KENNETH",
        "middle_name": "B.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "OR 079043505N3",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsboro, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2007; 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.