Individual provider Active NPI

Kimberly Ann Storgaard, OTR

  • Specialist
  • Portland, OR
National Provider Identifier
1790995835
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1400627 Issued in OR
Practice address
4805 NE Glisan St
Portland, OR 97213-2933
Phone
(503) 215-6059
NPI assigned
May 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1400627 OR Primary

Addresses

Primary practice location

4805 NE Glisan St
Portland, OR 97213-2933

Mailing address

18008 SE 44TH Way
Vancouver, WA 98683-7402
Phone (360) 607-9105

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
1400627ORMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1790995835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18008 SE 44TH WAY",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986837402",
            "telephone_number": "360-607-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132933",
            "telephone_number": "503-215-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORGAARD",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "1400627",
            "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 Sep 27, 2013; 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.