Active NPI
Kendra Elizabeth Gaumitz, LPN
- Licensed Practical Nurse
- Portland, OR
National Provider Identifier
1720610694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 201805821LPN
- Practice address
- 10330 SE 32ND Ave Ste 110
Portland, OR 97222-6596 - Phone
- (503) 513-1300
- NPI assigned
- Feb 10, 2020
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 201805821LPN | OR | Primary |
Addresses
Primary practice location
10330 SE 32ND Ave Ste 110
Portland, OR 97222-6596
Mailing address
321 Steelhead St
Molalla, OR 97038-7635
Phone (503) 732-5348
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201805821LPN | Other | OR | OSBN |
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 |
|---|---|---|---|
| 201805821LPN | OR | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581292800000",
"number": "1720610694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 STEELHEAD ST",
"city": "MOLALLA",
"state": "OR",
"postal_code": "970387635",
"telephone_number": "503-732-5348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10330 SE 32ND AVE STE 110",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972226596",
"telephone_number": "503-513-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAUMITZ",
"first_name": "KENDRA",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-10",
"last_updated": "2020-02-10",
"certification_date": "2020-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OR",
"license": "201805821LPN",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OSBN",
"identifier": "201805821LPN",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.