Active NPI
Brian Kittleson
- Psychiatric/Mental Health Registered Nurse
- Wilsonville, OR
National Provider Identifier
1992125629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 201390111RN
- Practice address
- 29197 SW Orleans Ave
Wilsonville, OR 97070-7388 - Phone
- (503) 427-0182
- NPI assigned
- Apr 21, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 201390111RN | OR | Primary |
Addresses
Primary practice location
29197 SW Orleans Ave
Wilsonville, OR 97070-7388
Mailing address
PO Box 8459
Portland, OR 97207-8459
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 |
|---|---|---|---|
| 201390111RN | OR | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398038400000",
"number": "1992125629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8459",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972078459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29197 SW ORLEANS AVE",
"city": "WILSONVILLE",
"state": "OR",
"postal_code": "970707388",
"telephone_number": "503-427-0182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITTLESON",
"first_name": "BRIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-04-21",
"last_updated": "2014-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "OR",
"license": "201390111RN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilsonville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.