Active NPI
Michaeleen Gonzalez, LMT
- Point of Service
- Klamath Falls, OR
National Provider Identifier
1588019574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Point of Service
- License
- 21988
- Practice address
- 1775 Washburn Way
Suite a
Klamath Falls, OR 97603-4304 - Phone
- (541) 887-2507
- Fax
- (541) 887-2508
- NPI assigned
- Apr 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Point of Service | 305S00000X | 21988 | OR | Primary |
Addresses
Primary practice location
1775 Washburn Way
Suite a
Klamath Falls, OR 97603-4304
Mailing address
1775 Washburn Way
Suite a
Klamath Falls, OR 97603-4304
Phone (541) 887-2507
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 |
|---|---|---|---|
| 21988 | OR | MD | Point of Service |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461715200000",
"number": "1588019574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1775 WASHBURN WAY",
"address_2": "SUITE A",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976034304",
"telephone_number": "541-887-2507",
"fax_number": "541-887-2508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1775 WASHBURN WAY",
"address_2": "SUITE A",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976034304",
"telephone_number": "541-887-2507",
"fax_number": "541-887-2508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "MICHAELEEN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-27",
"last_updated": "2016-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "305S00000X",
"taxonomy_group": "",
"desc": "Point of Service",
"state": "OR",
"license": "21988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Klamath Falls, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.