NPI 1770045767 · live from the CMS NPI Registry
Bethany Kingsberry, APRN-NP
Nurse Practitioner, Gerontology in Portland, OR. National Provider Identifier 1770045767, active.
NPI record
| NPI | 1770045767 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Gerontology 363LG0600X |
| Practice location | 5050 Ne Hoyt St Ste 610, Portland, OR 97213 |
| Practice phone | 503-467-4761 |
| Mailing address | Po Box 3158, Portland, OR 97208 |
| Enumerated | April 1, 2019 |
| Last updated | March 4, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | R0121579 (OK) |
| Registered Nurse, Registered Nurse First Assistant | 163WR0006X | R0121579 (OK) |
| Nurse Practitioner | 363L00000X | 200647 (OK) |
| Nurse Practitioner | 363L00000X | 10036936 (OR) |
| Nurse Practitioner, Acute Care | 363LA2100X | 200647 (OK) |
| Nurse Practitioner, Gerontology primary | 363LG0600X | 10036936 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.