MR. KYLE EDWARD ANDERSON (NPI# 1912540980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912540980 |
| Entity Type | Individual |
| Full Name | MR. KYLE EDWARD ANDERSON |
| Credential | PMHNP-BC |
| Practice Address |
1410 Ne 106th Ave Portland OR 97220-3934 |
| Practice Telephone | 2102895953 |
| Mailing Telephone | 2102895953 |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2020-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
202007455NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP143637 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8026 Floyd Curl Dr, San Antonio, TX 782293915 | 2105758110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932523792 | Kyle Charles Anderson | Physical Therapist | 15 S 1000 E Ste 25, Payson, UT 84651-5595 | 2014-02-13 |
| 1326383100 | Kyle C Anderson | Nurse Anesthetist, Certified Registered | 22 Bridge St Ste 9, Concord, NH 03301-4987 | 2012-12-04 |
| 1720221617 | Kyle Anderson | Dermatology | 11301 Nall Ave Fl 2, Bmo Harris Bank Bldg., Leawood, KS 66211-1672 | 2009-04-08 |
| 1952383176 | Kyle Anderson | Orthopaedic Surgery | 32270 Telegraph Rd Ste 220b, Bingham Farms, MI 48025-2456 | 2005-11-15 |
| 1770576332 | Kyle R. Anderson | Internal Medicine | 730 Malabar Rd, Malabar, FL 32950-3140 | 2005-08-29 |
| 1447870571 | Kyle Anderson | Counselor | 3430 Sw 320th St, Federal Way, WA 98023-2292 | 2020-04-18 |
| 1992333215 | Kyle John Anderson | Student in an Organized Health Care Education/Training Program | 8701 W Watertown Plank Rd, Milwaukee, WI 53226-3548 | 2020-03-31 |
| 1417580945 | Kyle Anderson | Pharmacist | 812 S 1st Ave, Iowa City, IA 52245-5208 | 2020-02-12 |
| 1982170676 | Kyle Christian Anderson | Nurse Practitioner | 1205 S Grange Ave Ste 407, Sioux Falls, SD 57105-0410 | 2018-10-19 |
| 1750800017 | Kyle Anderson | Case Manager/Care Coordinator | 675 Bartson Rd, Fremont, OH 43420-9672 | 2017-09-18 |
| Street Address |
1410 NE 106TH AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220-3934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316017585 | Theresa Bunker | Nurse Practitioner | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2006-11-08 |
| 1558975151 | Amber Rae Oyama | Clinic/Center | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2020-09-02 |
| 1598316572 | Trevor Scott Rachko | Nurse Practitioner | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2019-09-22 |
| 1801449301 | Eva Cicilian | Registered Nurse | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2019-07-23 |
| 1891128005 | Neisha Caldwell | Counselor | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2013-08-12 |
| 1659622454 | Elizabeth Jane Sadock | Psychologist | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2012-09-20 |
| 1366751638 | Brittany Lyn Kolluru | Naturopath | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2010-10-04 |
| 1659604825 | Marti L Baird | Nurse Practitioner | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2009-09-04 |
| 1164576617 | Gwyneth Theresa Jones | Nurse Practitioner | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2007-01-22 |
| 1548330715 | Bridge City Family Medical Clinic, PC | Clinic/Center | 1410 Ne 106th Ave, Portland, OR 97220-3934 | 2006-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154920148 | Hardcore Happy LLC | Nurse Practitioner | 740 Ne 116th Ct, Portland, OR 97220-2223 | 2020-10-20 |
| 1457967325 | Megan L Langworthy | Nurse Practitioner | 1914 Se 46th Ave, Portland, OR 97215-3148 | 2020-09-16 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1730712290 | Lucy Anne Bloedon | Nurse Practitioner | 4020 Sw Iowa St, Portland, OR 97221-3423 | 2020-02-12 |
| 1346802733 | Compass Psychiatric Wellness LLC | Nurse Practitioner | 4300 Ne Fremont St Ste 260, Portland, OR 97213-1100 | 2019-07-05 |
| 1548721871 | Cooke Therapy Pllc | Nurse Practitioner | 1125 Se Madison St Ste 102, Portland, OR 97214-3600 | 2019-03-28 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1467969220 | Nw Mind-body Wellness, LLC | Nurse Practitioner | 16986 Nw Lynch Ln, Portland, OR 97229-1221 | 2018-01-02 |
| 1811441348 | Anthony Hoy | Nurse Practitioner | 5562 Se Pine St, Portland, OR 97215-1276 | 2016-08-12 |
| 1700241254 | Jacqueline J Cole | Nurse Practitioner | 5228 Ne Hoyt St Ste 300, Portland, OR 97213-3055 | 2015-12-29 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on MR. KYLE EDWARD ANDERSON.
| 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.