MISS KELLIE RENEE GRAHAM (NPI# 1679090757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679090757 |
| Entity Type | Individual |
| Full Name | MISS KELLIE RENEE GRAHAM |
| Credential | FNP |
| Practice Address |
3303 Sw Bond Ave Ste 9 Portland OR 97239-4501 |
| Practice Telephone | 5034947400 |
| Practice Fax Number | 5034944749 |
| Mailing Telephone | 5034947400 |
| Mailing Fax Number | 5034944749 |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2018-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201809498NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3303 SW BOND AVE STE 9 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801862255 | Nandita Chaturvedi Gupta | Internal Medicine | 3303 Sw Bond Ave Ste 9, Portland, OR 97239-4501 | 2006-02-26 |
| 1487127676 | Courtney Margaret Craigan | Nurse Practitioner | 3303 Sw Bond Ave Ste 9, Portland, OR 97239-4501 | 2019-01-10 |
| 1598219081 | Erin M. Heinemann | Social Worker | 3303 Sw Bond Ave Ste 9, Portland, OR 97239-4501 | 2016-08-12 |
| 1346601754 | Katherine O Spira | Registered Nurse | 3303 Sw Bond Ave Ste 9, Portland, OR 97239 | 2016-03-11 |
| 1750788113 | Sydney Elizabeth Thompson | Nurse Practitioner | 3303 Sw Bond Ave Ste 9, Portland, OR 97239 | 2014-12-01 |
| 1902201957 | Stephanie Khouw | Nurse Practitioner | 3303 Sw Bond Ave Ste 9, Portland, OR 97239-4501 | 2014-11-01 |
| 1336497718 | Meghan Mannello | Genetic Counselor, MS | 3303 Sw Bond Ave Ste 9, Portland, OR 97239-4501 | 2012-08-16 |
| 1154687622 | Luke Ivan Masha | Internal Medicine | 3303 Sw Bond Ave Ste 9, Portland, OR 97239-4501 | 2012-04-09 |
| 1013200302 | Catherine Wong | Internal Medicine | 3303 Sw Bond Ave Ste 9, Portland, OR 97239-4501 | 2011-05-19 |
| 1265743686 | Harsh Golwala | Internal Medicine | 3303 Sw Bond Ave Ste 9, Portland, OR 97239 | 2010-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822794 | Danielle Langer | Nurse Practitioner | 35 Ridgeview Rd, Portland, CT 06480-4014 | 2020-08-23 |
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1114566650 | Sadie Garnache-poirier | Nurse Practitioner | 65 W Commercial St Ste 107, Portland, ME 04101-4789 | 2020-01-02 |
| 1902441629 | Jennifer Marie Colpitts | Nurse Practitioner | 1600 Congress St Ste B, Portland, ME 04102-2148 | 2019-11-18 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1265081640 | Christina Lee | Nurse Practitioner | 144 State St # 1, Portland, ME 04101-3776 | 2019-09-09 |
| 1407401474 | Abby Christine Vopal | Nurse Practitioner | 66 Bramhall St Fl 1, Portland, ME 04102-3355 | 2019-08-07 |
| 1770145294 | Cynthia Marie Martinez | Nurse Practitioner | 1145 Austin St, Portland, TX 78374-2013 | 2019-07-04 |
| 1528532306 | Matthew James Keelin | Nurse Practitioner | 6801 Ne Cornfoot Rd, Portland, OR 97218-2743 | 2019-01-15 |
| 1659847580 | Colleen Jeanette Scott | Nurse Practitioner | 650 Nw Irving St, Portland, OR 97209-1272 | 2018-10-18 |
| Find all providers in PORTLAND | ||||
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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.