DR. KYLIE CLARK (NPI# 1861788101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861788101 |
| Entity Type | Individual |
| Full Name | DR. KYLIE CLARK |
| Credential | M.D. |
| Practice Address |
5050 Ne Hoyt St Suite B55 Portland OR 97213-2991 |
| Practice Telephone | 5032335393 |
| Practice Fax Number | 5036598984 |
| Mailing Telephone | 5032335393 |
| Mailing Fax Number | 5036598984 |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2014-12-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD168562 | OR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 2011018538 | MO | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500674850 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144773680 | Kylie Elizabeth Clark | Physical Therapist | 251 Violet St, Unit 150, Golden, CO 80401-6723 | 2016-08-02 |
| Street Address |
5050 NE HOYT ST SUITE B55 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-2991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558364570 | Bruce Wilson Dana | Internal Medicine | 5050 Ne Hoyt St, Ste 256, Portland, OR 97213-2982 | 2005-05-23 |
| 1780136242 | Crystal Marie Rodriguez | Physician Assistant | 5050 Ne Hoyt St, Suite 240, Portland, OR 97213-2991 | 2016-11-01 |
| 1558810820 | Janina Browne | Physician Assistant | 5050 Ne Hoyt St, 454, Portland, OR 97213-2991 | 2016-09-28 |
| 1285181974 | Lena Soo Hee Wood | Advanced Practice Midwife | 5050 Ne Hoyt St, Suite 353, Portland, OR 97213-2991 | 2016-09-09 |
| 1780131532 | Hayley M Cusick | Physician Assistant | 5050 Ne Hoyt St, Suite 511, Portland, OR 97213-2991 | 2016-09-08 |
| 1801249164 | Lauren Berman | Speech-Language Pathologist | 5050 Ne Hoyt St, #315, Portland, OR 97213 | 2016-07-21 |
| 1457709123 | Emily C. Nguyen, M.d., P.C. | Specialist | 5050 Ne Hoyt St, Suite 611, Portland, OR 97213-2991 | 2016-06-02 |
| 1356798086 | Bryce Beard | Student in an Organized Health Care Education/Training Program | 5050 Ne Hoyt St, Ste 540, Portland, OR 97213-2991 | 2016-05-23 |
| 1619324340 | Monica Johnson | Student in an Organized Health Care Education/Training Program | 5050 Ne Hoyt St, Ste 540, Portland, OR 97213-2991 | 2016-05-23 |
| 1184071813 | Rahwa Shumet Ghebremichael | Student in an Organized Health Care Education/Training Program | 5050 Ne Hoyt St, Ste 540, Portland, OR 97213-2991 | 2016-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1578049631 | Credena Health LLC | Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| 1023507795 | Karissa Lynn Schwartz | Speech-Language Pathologist | Providence Portland Medical Center, 4805 Ne Glisan St, Portland, OR 97213 | 2018-05-08 |
| 1861944506 | James Livingston Taylor | Chiropractor | 5212 Ne Sacremento St., Portland, OR 97213 | 2016-10-28 |
| 1962958520 | Caitlin Turner | Massage Therapist | 4317 Ne Tillamook St., Portland, OR 97213 | 2016-09-01 |
| 1326407008 | Julianna Vermeys | Counselor | 4605 Ne Fremont St., 209a, Portland, OR 97213 | 2016-02-23 |
| 1881059822 | Thomas Michael Barrett | Counselor | 5228 Ne Hoyt St. Bldg. B, Portland, OR 97213 | 2015-12-17 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1447663810 | Anh Linh Hoang | Pediatrics | 9243 Ne Glisan St, Portland, OR 97220-4533 | 2014-06-03 |
| 1255771671 | Steven Donald Mcgaughey | Pediatrics | Ohsu Doernbecher, 3181 Sw Sam Jackson Park Road, Portland, OR 97239-1002 | 2013-06-29 |
| 1508109539 | Ramya Mishra Jariwala | Pediatrics | 9155 Sw Barnes Rd Ste 840, Portland, OR 97225 | 2013-03-28 |
| 1801162789 | Gabriel Larson | Pediatrics | 700 S.w. Campus Drive, 7th Floor, Portland, OR 97239 | 2012-03-26 |
| 1376833616 | Ashley Holsen | Pediatrics | 10000 Se Main St Ste 30, Portland, OR 97216-2461 | 2011-04-07 |
| 1477852259 | Kelsey Linde Richardson | Pediatrics | 3181 Sw Sam Jackson Hall Rd, Portland, OR 97239 | 2011-03-20 |
| 1093038986 | Seth M Williams | Pediatrics | 2801 N. Gantenbein Legacy Emanuel Medical Center, Randall Children's Hospital, Portland, OR 97227 | 2010-03-05 |
| 1669600904 | Erica Empey Benthin | Pediatrics | 205 Nw 16th Ave Apt 7, Portland, OR 97209-2648 | 2009-06-25 |
| 1871720136 | Corey Adair Fish | Pediatrics | 6924 Ne Sandy Blvd, Portland, OR 97213-5256 | 2009-06-14 |
| 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.