Miss Alter Ego Salon, LLC

Primary specialty

Medical Art Specialist/TechnologistTaxonomy code 246ZA2600X

Legal business name

MISS ALTER EGO SALON, LLC

Practice address

21185 NW West Union Rd
Hillsboro, OR 97124-8543

Phone

(503) 206-9472

NPI assigned

Feb 19, 2020

Organization subpart

No

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

Authorized official

Name

Terrie Lynne KlotzNPI 1295323715

Title

Owner/Operator

Phone

(503) 206-9472

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Terrie Lynne Klotz

  • Medical Art Specialist/Technologist
  • Hillsboro, OR
  • NPI 1295323715

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1609409523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21185 NW WEST UNION RD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971248543",
            "telephone_number": "503-206-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21185 NW WEST UNION RD",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971248543",
            "telephone_number": "503-206-9472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISS ALTER EGO SALON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "KLOTZ",
        "authorized_official_first_name": "TERRIE",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "503-206-9472"
    },
    "taxonomies": [
        {
            "code": "246ZA2600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Art, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Araceli Miranda
• Derek Mires, CRM
• Nomarie L. Miro Hernandez
• Kristina Mironichenko, RPH
• Karen A Mischke Nell, WHCNP
• Dionne-Etta Mitchell
• Jordan Alexander Mitchell
• Marielle V Mitchell, DPT
• Michael Darren Mitchell, M.D.
• Timur Mitin, M.D., PH.D.

• Medical Art Specialist/Technologist in Hillsboro, OR
• Providers in Hillsboro, OR by specialty
• Medical Art Specialist/Technologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.