Basic Information
| Provider Information | |||||||||
| NPI: | 1386897809 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KLING | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 92900 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972920900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036658176 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 831 NW COUNCIL DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | GRESHAM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970303721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036658176 | ||||||||
| FaxNumber: | 5036658178 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/28/2008 | ||||||||
| LastUpdateDate: | 08/28/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 201393371NP-PP | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | 363LC0200X | 18610 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | GR0079700 | 01 | CA | MEDICAL GROUP | OTHER | ZZZ13858Z | 01 | CA | GROUP MEDICARE | OTHER | 1316054737 | 01 | CA | GROUP NPI | OTHER | RN 557967 | 01 | CA | REGISTERED NURSE | OTHER | NP 18610 | 01 | CA | NURSE PRACTITIONER | OTHER |