MR. KYLE EDWARD ANDERSON PMHNP-BC NPI 1912540980

NPI Information

NPI: 1912540980
Provider Name: MR. KYLE EDWARD ANDERSON, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1410 NE 106TH AVE
PORTLAND, OR
ZIP 97220
Phone: (210) 289-5953
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MR. Kyle Edward Anderson, PMHNP-BC is a psychiatric/mental health nurse practitioner in Portland, OR. MR. Kyle Edward Anderson, PMHNP-BC NPI is 1912540980. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1410 NE 106TH AVE
PORTLAND, OR
ZIP 97220-934
Phone: (210) 289-5953

The NPI 1912540980 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/23/2019 and was last updated on 11/5/2020.

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	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP143637	TEXAS	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	202007455NP-PP	OREGON	Yes

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: 4/28/2024

NPI Synchronization or Removal

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