KELLY MCMULLEN (NPI# 1558892471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558892471 |
| Entity Type | Individual |
| Full Name | KELLY MCMULLEN |
| Credential | LMT |
| Practice Address |
819 Se Morrison St Suite 140 Portland OR 97214-6307 |
| Practice Telephone | 7024806028 |
| Mailing Telephone | 7024806028 |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 405300000X | Prevention Professional | 20211 | OR | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972744779 | Kelly Lynne Mcmullen | Specialist/Technologist | 215 Cameron Hall, Virginia Military Institute, Lexington, VA 24450 | 2009-03-09 |
| 1639528144 | Kelly Ann Mcmullen | Counselor | 821 Eastern Shore Dr, Salisbury, MD 21804-5943 | 2016-06-06 |
| 1174655807 | Kelly Edith Mcmullen | Family Medicine | 1960 Ogden St Ste 460, Denver, CO 80218-3670 | 2007-03-09 |
| Street Address |
819 SE MORRISON ST SUITE 140 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97214-6307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467535823 | Judith Marie Simonsen | Acupuncturist | 819 Se Morrison St, Suite 120, Portland, OR 97214-6307 | 2006-10-21 |
| 1487123824 | Michael Mottmann | Chiropractor | 819 Se Morrison St, Portland, OR 97214-6307 | 2018-11-15 |
| 1487103362 | Alexandria Nguyen-johnson | Naturopath | 819 Se Morrison St, Ste 115, Portland, OR 97214-6307 | 2016-10-03 |
| 1285189530 | Miguel D Carreon | Nurse Practitioner | 819 Se Morrison St, Portland, OR 97214 | 2016-08-16 |
| 1114386646 | Elizabeth Bourgeois | Acupuncturist | 819 Se Morrison St, Suite 140, Portland, OR 97214-6307 | 2016-02-11 |
| 1831592625 | Emerald Mansfield | Naturopath | 819 Se Morrison St, Ste 115, Portland, OR 97214-6307 | 2014-10-07 |
| 1245633049 | Emerald Family Medicine LLC | Clinic/Center | 819 Se Morrison St, Ste 115, Portland, OR 97214-6307 | 2014-10-07 |
| 1508287152 | Bridget Fragale Lmt | Massage Therapist | 819 Se Morrison St, Portland, OR 97214-6307 | 2013-12-30 |
| 1639519374 | Meagen M Alm | Massage Therapist | 819 Se Morrison St, Suite 115, Portland, OR 97214-6307 | 2013-06-26 |
| 1447594866 | Krista M Weikel Delaplane | Naturopath | 819 Se Morrison St, Ste 115, Portland, OR 97214-6307 | 2012-11-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773155 | Mamie Nzigire Zagabe | Peer Specialist | 605 Se Cesar Estrada Chavez Blvd, Portland, OR 97214 | 2020-09-01 |
| 1336772243 | Alexandra Mcbryde | Acupuncturist | 959 Se Division St, #315, Portland, OR 97214 | 2020-02-19 |
| 1356973770 | Laura Kille | Counselor | Wise Counsel and Comfort, 2045 Se Hawthorne Blvd., Portland, OR 97214 | 2020-02-05 |
| 1639616436 | Erin Elizabeth Weaver | Acupuncturist | 1330 Se Cesar E Chavez Blvd. Center for Natural Meidici, Portland, OR 97214 | 2017-01-31 |
| 1780126045 | Katherine Aravamudan, Lpc, LLC | Community/Behavioral Health | 1312 E. Burnside Street, Portland, OR 97214 | 2016-11-17 |
| 1003358441 | Michelle Jean Meadows | Massage Therapist | 2804 Se Lincoln St, Portland, OR 97214 | 2016-11-16 |
| 1629429311 | Stephanie Tolentino | Counselor | 605 Se Cesar E Chavez Blvd., Portland, OR 97214 | 2016-06-24 |
| 1790141166 | Marian Iris Dixon | Massage Therapist | 3810 Se Belmont St., Earthbody Wellness Center East, Portland, OR 97214 | 2016-01-14 |
| 1194194589 | Lutheran Community Services Northwest | Community/Behavioral Health | 605 Se Cesar E Chavez Bld, Portland, OR 97214 | 2015-09-16 |
| 1497123566 | Michele R. Stokes | Specialist | 2311 East Burnside B1, Portland, OR 97214 | 2015-09-08 |
| Find all providers in zip 97214 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407388176 | First Class Therapy | Prevention Professional | 114 Faculty Hill Rd, Portland, TN 37148-4257 | 2017-03-31 |
| 1376083121 | Caroline Jean Caulfield | Prevention Professional | 14232 Se Mill Ct, Portland, OR 97233-2370 | 2017-02-27 |
| 1568002392 | Jennifer Liana Siegel | Prevention Professional | 1312 Sw Washington St, Portland, OR 97205-2327 | 2020-01-09 |
| 1558897181 | Christina Evans Gagosian | Prevention Professional | 10300 Sw Greenburg Rd, Suite 410, Portland, OR 97223-5410 | 2017-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598299729 | Sarah Rebecca Miller | Prevention Professional | 16493 Bluewood Pl # 5, La Pine, OR 97739-7526 | 2017-04-13 |
| 1205446663 | Vivian June Shaw | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-07-31 |
| 1629687876 | Rachel Marie Hoptowit | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-07-23 |
| 1841809134 | Nicole Grace Whiskeyjack | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2020-07-23 |
| 1750864229 | Abelardo Lozano | Prevention Professional | 46314 Timine Way, Pendleton, OR 97801-9417 | 2018-09-11 |
| 1194260927 | Forwardstride | Prevention Professional | 18218 Sw Horse Tale Dr, Beaverton, OR 97007-9789 | 2017-01-03 |
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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.