Active NPI
Kimberlee Jo Gabourel, MSPT
- Physical Therapist
- Portland, OR
National Provider Identifier
1982896411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2591
- Practice address
- 6530 SW 30TH Ave
Portland, OR 97239-1007 - Phone
- (503) 244-7533
- Fax
- (503) 244-2396
- NPI assigned
- Aug 17, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2591 | OR | Primary |
Addresses
Primary practice location
6530 SW 30TH Ave
Portland, OR 97239-1007
Mailing address
7601 SW 194TH Ter
Aloha, OR 97007-5502
Phone (503) 642-5253
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premere Rehab LLC | Physical Therapist | Current | Accepting new patients |
Locations
8100 SW Nyberg St
Ste 200
Tualatin, OR 97062
Phone (503) 570-3365
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187308800000",
"number": "1982896411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7601 SW 194TH TER",
"city": "ALOHA",
"state": "OR",
"postal_code": "970075502",
"telephone_number": "503-642-5253"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6530 SW 30TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972391007",
"telephone_number": "503-244-7533",
"fax_number": "503-244-2396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GABOUREL",
"first_name": "KIMBERLEE",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-17",
"last_updated": "2007-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "2591",
"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 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.