Active NPI
Keysha Rae Kendall
- Student in an Organized Health Care Education/Training Program
- Portland, OR
National Provider Identifier
1902155583
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 6560340
- Practice address
- 1500 NE Irving St
Suite 250
Portland, OR 97232 - Phone
- (503) 233-4356
- NPI assigned
- Aug 29, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 6560340 | OR | Primary |
Addresses
Primary practice location
1500 NE Irving St
Suite 250
Portland, OR 97232
Mailing address
4528 SE Roethe Rd
Apartment 51
Milwaukie, OR 97267
Phone (503) 686-0756
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 |
|---|---|---|---|
| 6560340 | OR | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1902155583",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4528 SE ROETHE RD",
"address_2": "APARTMENT 51",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97267",
"telephone_number": "503-686-0756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 NE IRVING ST",
"address_2": "SUITE 250",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97232",
"telephone_number": "503-233-4356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENDALL",
"first_name": "KEYSHA",
"middle_name": "RAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OR",
"license": "6560340",
"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 Aug 29, 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.