KIMBERLY MARIE MINOR


Address: 10564 Se Washington St, Portland, OR 97216-2809
Phone: 5032289229

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 175T00000X Peer Specialist 18-CRM-027 OR Other Service Providers

Other Providers KIMBERLY MINOR

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

Office Location

Street Address 10564 SE WASHINGTON ST
City PORTLAND
State OR
Zip Code 97216-2809

Providers in the same location

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

Providers in the same zip code

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 Information

Taxonomy Code 175T00000X
Grouping Other Service Providers
Classification Peer Specialist

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Competitor

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City PORTLAND
Zip Code 97216

Improve Information

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Dataset Information

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.

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