Kiley Brevik

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R8642 Issued in OR

Practice address

14800 NW Cornell Rd Apt 27B
Portland, OR 97229-5484

Phone

(425) 478-2135

NPI assigned

Jan 27, 2021

Reactivated

Oct 5, 2021

Last updated

Mar 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1619568243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 NW CORNELL RD APT 27B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295484",
            "telephone_number": "425-478-2135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 NW CORNELL RD APT 27B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295484",
            "telephone_number": "425-478-2135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2355 State St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973014541",
            "country_code": "US",
            "telephone_number": "971-361-6936",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11740 SW 68th Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972239058",
            "country_code": "US",
            "telephone_number": "425-477-4216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREVIK",
        "first_name": "KILEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "deactivation_date": "2021-08-09",
        "reactivation_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R8642",
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darrell Cameron Brett, M.D.
• Jamie Breunig
• Kathryn Breunig, LMT
• Richard J Breunissen, QMHP-R
• Selena A Brever
• Stacee Brewer-Gordon
• Brandon Brewer
• Brenda C. Brewer, ARNP
• Cindy Jane Brewer, RDH,BS
• Erin Brewer Brewer, RD

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.