KELLY DIANE BOEVE (NPI# 1548755341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548755341 |
| Entity Type | Individual |
| Full Name | KELLY DIANE BOEVE |
| Credential | LPC |
| Practice Address |
10700 Sw Beaverton Hillsdale Hwy Ste 450 Beaverton OR 97005-4736 |
| Mailing Address |
2984 Sw 153rd Dr Beaverton OR 97003-5157 |
| Practice Telephone | 9712382180 |
| Mailing Telephone | 9712382180 |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2020-06-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
C4643 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | LICENSED PROFESSIONAL COUNSELOR | C4643 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2984 Sw 153rd Dr, Beaverton, OR 970035157 | 5037479186 | |
| 12555 Sw 1st St, Beaverton, OR 970050546 | 9712382180 | |
| 10700 Sw Beaverton Hillsdale Hwy Ste 560, Beaverton, OR 970054791 | 9712382180 | |
| 207 Sw 1st St, Enterprise, OR 978281203 | 5414264525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063701175 | Kelly Jo Boeve | Psychologist | 12265 James St, Holland, MI 49424-8613 | 2011-03-30 |
| Street Address |
10700 SW BEAVERTON HILLSDALE HWY STE 450 |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97005-4736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295878239 | Mary Hacopian | Psychologist | 10700 Sw Beaverton Hillsdale Hwy Ste 450, Beaverton, OR 97005-4736 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154945053 | Krista Lowe Schimmelbusch | Student in an Organized Health Care Education/Training Program | 12730 Sw 3rd St., Beaverton, OR 97005 | 2020-06-05 |
| 1346882578 | Mireya Elissa Nunez I | Counselor | 12665 Sw Center Street, Suite 100, Beaverton, OR 97005 | 2019-10-09 |
| 1548816879 | Logan James Patzlaff | Behavior Technician | 6200 Sw Artic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-08-13 |
| 1528521424 | Alex Taylor Foerman | Behavior Technician | 6200 Sw Arctic Drive Beaverton, Or 97005, Beaverton, OR 97005 | 2019-04-09 |
| 1285193003 | Hazelnut Dental LLC | Clinic/Center | 10773 Sw Beaverton-hillsdale Hwy, Ste B, Beaverton, OR 97005 | 2019-03-19 |
| 1992286348 | Kathryn Wallner | Counselor | 14205 Sw Farmington Road, Suite 160, Beaverton, OR 97005 | 2018-08-23 |
| 1699265058 | Meaghan Mikulic | Social Worker | 14355 Sw Allen Blvd Suite 150, Beaverton, OR 97005 | 2018-05-11 |
| 1629568936 | Aimee J Nelson | Massage Therapist | 10700 Sw Beaverton Hillsdale Hwy Ste 465, Beaverton, OR 97005 | 2018-05-11 |
| 1093221780 | Ember Dahl | Massage Therapist | 12655 Sw Center St Ste 530, Beaverton, OR 97005 | 2017-12-18 |
| 1033667456 | Andre Vo | Pharmacist | 2575 Sw Walker Rd, Beaverton, OR 97005 | 2016-09-14 |
| Find all providers in zip 97005 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100339 | Alexander Deussen | Counselor | 4770 Sw 165th Ave, Beaverton, OR 97078-1922 | 2020-09-29 |
| 1073138145 | Therese Madden Rose | Counselor | 5965 Sw Menlo Dr Apt A211, Beaverton, OR 97005-4820 | 2020-06-14 |
| 1679130256 | Brittany Shannon Eide | Counselor | 4900 Sw Griffith Dr Ste 273, Beaverton, OR 97005-5607 | 2019-05-20 |
| 1881168474 | Lisa Bradfield | Counselor | 4555 Sw 142nd Ave Apt 4555sw, Beaverton, OR 97005-2534 | 2019-01-16 |
| 1578044608 | Tiffany C. Del Pozo | Counselor | 11950 Sw 2nd St, Beaverton, OR 97005-8923 | 2018-08-27 |
| 1225518202 | Heleen Woest | Counselor | 4145 Sw Watson Ave Ste 350, Beaverton, OR 97005-2191 | 2018-08-18 |
| 1013410455 | Taryn Weslie Van Vliet | Counselor | Forward Stride, 23839 Sw Daniel Rd., Beaverton, OR 97007 | 2018-03-12 |
| 1881105351 | Rebekah Springs | Counselor | 3800 Sw Cedar Hills Blvd Ste 120, Beaverton, OR 97005-4753 | 2017-10-23 |
| 1417479130 | Ruth Hescock | Counselor | 6700 Sw 105th Ave Ste 203, Beaverton, OR 97008-8824 | 2017-07-14 |
| 1619407830 | Sania Lodhi | Counselor | 1510 Sw 172nd Terrace, 304, Beaverton, OR 97003 | 2017-06-20 |
| Find all providers in BEAVERTON | ||||
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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.