Active NPI
Elizabeth G Klein, MD
- Family Medicine Physician
- Milwaukie, OR
National Provider Identifier
1710916051
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD17066
- Practice address
- 10330 SE 32ND Ave
Suite 205
Milwaukie, OR 97222-6587 - Phone
- (503) 513-8950
- Fax
- (503) 513-8951
- NPI assigned
- Jun 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD17066 | OR | Primary |
Addresses
Primary practice location
10330 SE 32ND Ave
Suite 205
Milwaukie, OR 97222-6587
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 033568 | Medicaid | OR | |
| P00239989 | Other | OR | RRMEDICARE |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD17066 | OR | MD | Family Medicine Physician |
| 17066 | OR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347408000000",
"number": "1710916051",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "503-215-6494",
"fax_number": "503-215-6644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10330 SE 32ND AVE",
"address_2": "SUITE 205",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "972226587",
"telephone_number": "503-513-8950",
"fax_number": "503-513-8951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEIN",
"first_name": "ELIZABETH",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2012-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD17066",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "033568",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RRMEDICARE",
"identifier": "P00239989",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukie, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.