Breanna Grisham, IBCLC, RDMS

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

Practice address

8514 N Newman Ave
Portland, OR 97203-3568

Phone

(503) 442-3653

NPI assigned

Nov 23, 2022

Last updated

Nov 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lactation Consultants of America

  • Lactation Consultant (Non-RN)
  • Big Bear City, CA
  • NPI 1740929694

  Lactation Consultant, Non-RN

  NPD (past)

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1962111427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8514 N NEWMAN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972033568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8514 N NEWMAN AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972033568",
            "telephone_number": "503-442-3653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "BREANNA",
        "credential": "IBCLC, RDMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grin in-Home Care Inc. (Comfort Keepers)
• Michaele Erin Grina, PHD
• Monica Lyn Gripp, RN, BSN
• Loretta Marie Grisaffi, LMT
• Laurence Grisanti, PMHNP
• Elka Janis Grisham, LCSW
• Faith Marie Grisham
• Mikhail P Grishchuk
• Max V Grishkevich, MD
• Simon V Grishkevich, MD

• Lactation Consultant (Non-RN) in Portland, OR
• Providers in Portland, OR by specialty
• Lactation Consultant (Non-RN) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.