Individual provider Active NPI

Kerry Ellen Grether

  • Lactation Consultant (Non-RN)
  • Portland, OR
National Provider Identifier
1750246872
Registry record updated Dec 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
10265111 Issued in OR
Practice address
3928 NE 13TH Ave
Portland, OR 97212-1305
Phone
(503) 956-2579
NPI assigned
Dec 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN)Group: 193400000X SINGLE SPECIALTY GROUP 174N00000X 10265111 OR Primary

Addresses

Primary practice location

3928 NE 13TH Ave
Portland, OR 97212-1305

Mailing address

3928 NE 13TH Ave
Portland, OR 97212-1305
Phone (503) 956-2579

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

LicenseStateTypeSpecialty
10265111ORMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1766188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766188800000",
    "number": "1750246872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3928 NE 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121305",
            "telephone_number": "503-956-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3928 NE 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121305",
            "telephone_number": "503-956-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRETHER",
        "first_name": "KERRY",
        "middle_name": "ELLEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-20",
        "last_updated": "2025-12-20",
        "certification_date": "2025-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": "OR",
            "license": "10265111",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 20, 2025; 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.