DR. KIMBER L. PEZZONI (NPI# 1457365314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457365314 |
| Entity Type | Individual |
| Full Name | DR. KIMBER L. PEZZONI |
| Credential | M.D. |
| Practice Address |
9450 Sw Barnes Rd Ste 200 Portland OR 97225-6638 |
| Practice Telephone | 5032162025 |
| Practice Fax Number | 5032165529 |
| Mailing Telephone | 5032162025 |
| Mailing Fax Number | 5032165529 |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2014-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD26418 | OR | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
MD26418 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
9450 SW BARNES RD STE 200 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-6638 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417588112 | Danielle L Caldeira | Social Worker | 9450 Sw Barnes Rd Ste 200, Portland, OR 97225-6638 | 2020-01-31 |
| 1568954188 | Jordan Nicole Hubchik | Counselor | 9450 Sw Barnes Rd Ste 200, Portland, OR 97225-6638 | 2018-05-30 |
| 1760982953 | Renee Melton | Counselor | 9450 Sw Barnes Rd Ste 200, Portland, OR 97225-6638 | 2018-02-14 |
| 1770949315 | Rachael Sutta | Social Worker | 9450 Sw Barnes Rd Ste 200, Portland, OR 97225-6638 | 2016-01-12 |
| 1699131763 | Brent Moore | Counselor | 9450 Sw Barnes Rd Ste 200, Portland, OR 97225-6638 | 2016-01-05 |
| 1912380965 | Marion Mcnulty | Marriage & Family Therapist | 9450 Sw Barnes Rd Ste 200, Portland, OR 97225-6638 | 2015-07-08 |
| 1275875189 | Daniel Moran Fischer | Psychiatry & Neurology | 9450 Sw Barnes Rd Ste 200, Portland, OR 97225-6638 | 2013-03-19 |
| 1669705018 | Charlene Michelle Negus | Counselor | 9450 Sw Barnes Rd Ste 200, Portland, OR 97225-6638 | 2009-09-16 |
| 1720290489 | Jason R Stone | Psychiatry & Neurology | 9450 Sw Barnes Rd Ste 200, Portland, OR 97225-6638 | 2007-05-04 |
| 1891859971 | Tonia M Cottrell | Social Worker | 9450 Sw Barnes Rd Ste 200, Portland, OR 97225-6638 | 2006-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831455211 | Nicholas Austin | Psychiatry & Neurology | 3181 Sw Sam Jackson Park Rd Dept Of, Portland, OR 97239-3011 | 2012-04-10 |
| 1235446303 | Ervin Gene Stubbs | Psychiatry & Neurology | 7032 Sw 3rd Ave, Portland, OR 97219-2214 | 2010-09-09 |
| 1851525620 | Sarah Morgan Schrauben | Psychiatry & Neurology | 870 Se 82nd Ave., Portland, OR 97027 | 2009-05-08 |
| 1700077328 | Hanh Ngoc Nguyen | Psychiatry & Neurology | 5410 Sw Macadam Ave Ste 200, Portland, OR 97239 | 2007-08-08 |
| 1912116013 | John Barrows Chenoweth | Psychiatry & Neurology | 5410 S.w. Macadam Ave, Ste 200, Portland, OR 97239-3825 | 2007-05-22 |
| 1043340219 | Birgit Meyer | Psychiatry & Neurology | 3415 Se Powell Blvd., Portland, OR 97202 | 2007-03-06 |
| 1518029768 | Barbara Jean Baker | Psychiatry & Neurology | 1818 Se Division St, Portland, OR 97202-1159 | 2006-12-14 |
| 1790851574 | Dena K Drasin | Psychiatry & Neurology | 6834 Se 28th Ave, Portland, OR 97202-8705 | 2006-11-25 |
| 1700966926 | Jonathan Joseph Valen | Psychiatry & Neurology | 506 Sw 6th Ave, Ste 602, Portland, OR 97204-1533 | 2006-10-16 |
| 1275628380 | Kenneth David Holladay | Psychiatry & Neurology | 9830 Ne Cascades Pkwy, Suite 200, Portland, OR 97220-6832 | 2006-10-04 |
| Find all providers in PORTLAND | ||||
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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.