JUSTIN KIMBALL (NPI# 1275665572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275665572 |
| Entity Type | Individual |
| Full Name | JUSTIN KIMBALL |
| Practice Address |
12408 Se Fuller Rd Milwaukie OR 97222-1245 |
| Practice Telephone | 5032069631 |
| Mailing Telephone | 5032069631 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| Street Address |
12408 SE FULLER RD |
| City | MILWAUKIE |
| State | OR |
| Zip Code | 97222-1245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831731397 | Madalyn Kelly Yowell | Technician | 7809 Southeast Southgate Street, Milwaukee, OR 97222 | 2019-10-16 |
| 1336617448 | Nadia Yang | Social Worker | 2115 Se Adams St, Milwaukie, OR 97222 | 2018-11-06 |
| 1851892368 | Arrow Dental LLC | Dentist | 10505 Se 17th Avenue, Milwaukie, OR 97222 | 2018-02-21 |
| 1851814016 | Cathy Maria Andrew | Acupuncturist | 11022 Se Stanley Ave, Milwaukie, OR 97222 | 2017-07-19 |
| 1972025369 | Sarah Elizabeth Giles | Peer Specialist | 11097 Se 21st Ave., Milwaukie, OR 97222 | 2017-07-07 |
| 1366976292 | Brittany Reubendale | Physical Therapist | 12705 See River Rd, Portland, OR 97222 | 2017-04-18 |
| 1669916383 | Margie Hertz | Registered Nurse | 6406 Se Cedarcrest Drive, Milwaukie, OR 97222 | 2016-12-14 |
| 1952858094 | Alexis Escobar | Speech-Language Pathologist | 4560 Se International Way, Ste 100, Milwaukie, OR 97222 | 2016-09-07 |
| 1205295466 | Beth Ann Mills | Acupuncturist | 2025 Se Jefferson St Ste 106, Milwaukie, OR 97222 | 2016-02-16 |
| 1558744086 | Kyle Eugene Coan | Specialist | 3306 Se Wister St, Milwaukie, OR 97222 | 2015-07-01 |
| Find all providers in zip 97222 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861739682 | Jordan Marina Lilley | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2013-01-14 |
| 1194062919 | Heather Marie Alexander | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2013-01-14 |
| 1366799850 | Yuri Alexander | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-08-14 |
| 1528315801 | Stephen Anthony Walcott Jr. | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-08-06 |
| 1992067359 | Soohyun Andrew Lee | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-06-12 |
| 1184984346 | Destiny Robin Topolski | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-05-22 |
| 1477813574 | Amber Rae Stensen | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-05-22 |
| 1457619231 | Tiffany Christine Brooks | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-04-30 |
| 1073871414 | Justin Won-sun Hwang | Adult Companion | 5230 Se Roethe Rd, Milwaukie, OR 97267-5051 | 2012-04-23 |
| 1083941249 | Shannon Thorpe | Adult Companion | 17070 Se Mcloughlin Blvd, Milwaukie, OR 97267-4960 | 2009-11-09 |
| Find all providers in MILWAUKIE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.