Individual provider Active NPI

Kiana Lacaden

  • Athletic Trainer
  • Portland, OR
National Provider Identifier
1992343552
Registry record updated Dec 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
10186705 Issued in OR
Practice address
2219 SE 68TH Ave
Portland, OR 97215-4099
Phone
(503) 517-1063
NPI assigned
Dec 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 161017786 WA
Athletic Trainer 2255A2300X 10186705 OR Primary

Addresses

Primary practice location

2219 SE 68TH Ave
Portland, OR 97215-4099

Mailing address

2383 NW Oak Knoll PL
Beaverton, OR 97006-8074

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
10186705ORMDAthletic Trainer
161017786WAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1576195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576195200000",
    "number": "1992343552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2383 NW OAK KNOLL PL",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 SE 68TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972154099",
            "telephone_number": "503-517-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACADEN",
        "first_name": "KIANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-13",
        "last_updated": "2019-12-13",
        "certification_date": "2019-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "161017786",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "10186705",
            "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 Dec 13, 2019; 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.