KELSEY TATE (NPI# 1285264036) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285264036 |
| Entity Type | Individual |
| Full Name | KELSEY TATE |
| Credential | EFDA |
| Practice Address |
12450 Sw Walker Rd Beaverton OR 97005-1401 |
| Practice Telephone | 5032771050 |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2020-01-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | 117418 | OR | Dental Providers |
| Street Address |
12450 SW WALKER RD |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97005-1401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992242093 | Kaiser Foundation Health Plan of The Northwest | Dentist | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2017-01-26 |
| 1275164360 | Tracey Alice Remington | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2020-01-28 |
| 1245861343 | Rachelle Comedoy Encabo | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2020-01-28 |
| 1295365559 | Rosa Gonzalez Albarado | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2020-01-24 |
| 1316435043 | Emily Cannucci | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2018-04-27 |
| 1639616733 | Kaiser Foundation Health Plan of The Northwest | General Practice | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2017-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945053 | Krista Lowe Schimmelbusch | Student in an Organized Health Care Education/Training Program | 12730 Sw 3rd St., Beaverton, OR 97005 | 2020-06-05 |
| 1346882578 | Mireya Elissa Nunez I | Counselor | 12665 Sw Center Street, Suite 100, Beaverton, OR 97005 | 2019-10-09 |
| 1548816879 | Logan James Patzlaff | Behavior Technician | 6200 Sw Artic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-08-13 |
| 1528521424 | Alex Taylor Foerman | Behavior Technician | 6200 Sw Arctic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-04-09 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1992286348 | Kathryn Wallner | Counselor | 14205 Sw Farmington Road, Suite 160, Beaverton, OR 97005 | 2018-08-23 |
| 1699265058 | Meaghan Mikulic | Social Worker | 14355 Sw Allen Blvd Suite 150, Beaverton, OR 97005 | 2018-05-11 |
| 1629568936 | Aimee J Nelson | Massage Therapist | 10700 Sw Beaverton Hillsdale Hwy Ste 465, Beaverton, OR 97005 | 2018-05-11 |
| 1093221780 | Ember Dahl | Massage Therapist | 12655 Sw Center St Ste 530, Beaverton, OR 97005 | 2017-12-18 |
| 1033667456 | Andre Vo | Pharmacist | 2575 Sw Walker Rd, Beaverton, OR 97005 | 2016-09-14 |
| Find all providers in zip 97005 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821428483 | Austin Ruiz | Dental Assistant | 17715 Sw Robert Ln, Beaverton, OR 97007-1890 | 2013-11-19 |
| 1760493217 | Marzia Mohammady | Dental Assistant | 20628 Sw Celebrity Lane, Beaverton, OR 97007 | 2006-08-10 |
| 1275164360 | Tracey Alice Remington | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2020-01-28 |
| 1245861343 | Rachelle Comedoy Encabo | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2020-01-28 |
| 1295365559 | Rosa Gonzalez Albarado | Dental Assistant | 12450 Sw Walker Rd, Beaverton, OR 97005-1401 | 2020-01-24 |
| 1043857105 | Reagan Ravanzo Blanco | Dental Assistant | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2019-12-06 |
| 1487291043 | Jamie Lee Story | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2019-12-03 |
| 1104462340 | Amanda Noelle Jenkins | Dental Assistant | 17675 Sw Tv Hwy, Beaverton, OR 97003-4443 | 2019-11-22 |
| 1144866591 | Asela Agtay Wells | Dental Assistant | 4855 Sw Western Ave, Beaverton, OR 97005-3460 | 2019-11-20 |
| 1700421583 | Francisca Yac Riscajche | Dental Assistant | 17675 Sw Tualatin Valley Hwy, Beaverton, OR 97003-4443 | 2019-11-15 |
| Find all providers in BEAVERTON | ||||
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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.