KIMBERLY MARIE MINOR (NPI# 1770086761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770086761 |
| Entity Type | Individual |
| Full Name | KIMBERLY MARIE MINOR |
| Credential | CRM |
| Practice Address |
10564 Se Washington St Portland OR 97216-2809 |
| Mailing Address |
3910 Se Stark St Portland OR 97214-3241 |
| Practice Telephone | 5032289229 |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | 18-CRM-027 | OR | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689957953 | Kimberly H Minor | Pharmacist | 285 Dunlop Blvd Sw Ste A, Huntsville, AL 35824-1120 | 2011-09-23 |
| 1831365568 | Kimberly Minor | Marriage & Family Therapist | 2700 Cumberland Pkwy Se, Suite 120, Atlanta, GA 30339-3321 | 2008-05-02 |
| 1902918444 | Kimberly Joi Minor | Dentist | 4901 N Tryon St, Charlotte, NC 28213-7033 | 2006-08-31 |
| Street Address |
10564 SE WASHINGTON ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97216-2809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639233893 | James A Jensen | Counselor | 10564 Se Washington St, Portland, OR 97216-2809 | 2006-12-21 |
| 1538767264 | Lloyd Lawrence Jones | Peer Specialist | 10564 Se Washington St, 10564 Se Washington St, Portland, OR 97216 | 2020-10-14 |
| 1063019412 | Daniel James Spotanski | Peer Specialist | 10564 Se Washington St, Portland, OR 97216-2809 | 2020-10-07 |
| 1467078360 | Lloyd David Kneeland Jr. | Counselor | 10564 Se Washington St, Portland, OR 97216-2809 | 2020-06-17 |
| 1407476609 | Lindsay Martinez | Counselor | 10564 Se Washington St, Portland, OR 97216-2809 | 2020-04-17 |
| 1588290902 | Carole Ruth Hinojosa | Peer Specialist | 10564 Se Washington St, Portland, OR 97216-2809 | 2020-03-17 |
| 1629601463 | Craig Dwayne Freeman | Peer Specialist | 10564 Se Washington St, Portland, OR 97216-2809 | 2020-02-20 |
| 1134761166 | Patricia Jane Hanset | Peer Specialist | 10564 Se Washington St, Portland, OR 97216-2809 | 2019-10-10 |
| 1710528344 | Stacey Diane Beebe | Peer Specialist | 10564 Se Washington St, Portland, OR 97216-2809 | 2019-10-04 |
| 1629628797 | Annette Rachel Britton | Counselor | 10564 Se Washington St, Portland, OR 97216-2809 | 2019-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316468341 | Accident Care Chiropractic and Massage of Salem | Clinic/Center | 2168 Lancaster Dr. Ne, Portland, OR 97216 | 2017-06-29 |
| 1528508520 | Damone Brown | Peer Specialist | 10209 Se Washington St, Suite D, Portland, OR 97216 | 2017-02-24 |
| 1861937237 | Malachai Investments LLC | Clinical Medical Laboratory | 10,000 Se Main St, Ste 360, Portland, OR 97216 | 2016-12-21 |
| 1881136836 | Krista Marie Darnell | Occupational Therapy Assistant | 1475, Se 100th Avenue, Portland, OR 97216 | 2016-11-08 |
| 1821456559 | Sean Kelly | Counselor | 10564 Se Washington Street, Portland, OR 97216 | 2016-02-09 |
| 1174908321 | Phil Bergland | Counselor | 11220 Se Stark St, Suite 6, Portland, OR 97216 | 2015-07-29 |
| 1134507346 | Beth Lopez | Massage Therapist | 5814 Se Stark Street, Portland, OR 97216 | 2015-05-08 |
| 1982081477 | Amelia C Hunt | Counselor | 10564 Se Washinton Street, Portland, OR 97216 | 2015-05-04 |
| 1073907978 | Karen Ta | Emergency Medicine | 10300 Se Main St, Portland, OR 97216 | 2015-03-27 |
| 1265823298 | Laura Catherine Anderson | Occupational Therapist | 1475 Se 100th Avenue, Portland, OR 97216 | 2015-02-12 |
| Find all providers in zip 97216 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487255576 | Thomas Roy Hooks | Peer Specialist | 1221 Sw 11th Ave Apt 102, Portland, OR 97205-2143 | 2020-11-04 |
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1245896307 | Anthony James Hardy | Peer Specialist | 10336 Ne Wygant St, Portland, OR 97220-3368 | 2019-05-14 |
| 1881155596 | Laray Jermaine Thomas | Peer Specialist | 11509 Se Stephens St, Portland, OR 97216-3660 | 2019-03-26 |
| 1932684248 | Dorothy Joanna Burton | Peer Specialist | 3716 Ne Martin Luther King Blvd, Portland, OR 97212-1111 | 2018-10-02 |
| 1750886255 | Steven Wade | Peer Specialist | 4512 Ne Portland Hwy, Portland, OR 97218-1363 | 2018-03-27 |
| 1669991212 | Kimberly Jaye Randall | Peer Specialist | 17214 Se Division St Ste 2, Portland, OR 97236-1282 | 2017-09-14 |
| 1689103897 | Walter Bulter | Peer Specialist | 5257 Ne Martin Luther King Jr Blvd Ste 202, Portland, OR 97211-3283 | 2017-06-09 |
| 1306373543 | Brenda Kay Mitchell | Peer Specialist | 10373 Ne Hancock St Ste 132, Portland, OR 97220-3873 | 2017-05-18 |
| 1760914493 | Changing Perceptions | Peer Specialist | 1720 Nw Lovejoy St # 329, Portland, OR 97209-2346 | 2017-03-31 |
| 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.