ELEVEN ELEVEN LLC NPI 1548667918

NPI Information

NPI: 1548667918
Provider Name: ELEVEN ELEVEN, LLC
Classification: Specialist/Technologist, Other - 246ZA2600X
Specialization: Art, Medical
Entity Type: Organization
Address: 6714 SW 62ND PLACE
PORTLAND, OR
ZIP 97219
Phone: (503) 956-9773

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NPI Details

ELEVEN ELEVEN, LLC is an art and medical specialist technologist other in Portland, OR. ELEVEN ELEVEN, LLC NPI is 1548667918. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6714 SW 62ND PLACE
PORTLAND, OR
ZIP 97219
Phone: (503) 956-9773

The provider's authorized official is Erik Berntsen .
The authorized official title is Owner and has the following contact phone number (503) 956-9773.

The enumeration date for this NPI number is 12/1/2014 and was last updated on 12/1/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	246ZA2600X	Specialist/Technologist, Other	Art, Medical	BAP-TA-10133461	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	155097	OTHER	OREGON	CERTIFIED PERMANENT COSMETICS PROFESSIONAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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