Basic Information
Provider Information
NPI: 1700312410
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAN JOAQUIN
FirstName: KARA ESTER
MiddleName: FLORES
NamePrefix:  
NameSuffix:  
Credential: MSN, RN, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3303 S BOND AVE
Address2:  
City: PORTLAND
State: OR
PostalCode: 972394501
CountryCode: US
TelephoneNumber: 5034941775
FaxNumber: 5034944749
Practice Location
Address1: 3303 S BOND AVE
Address2:  
City: PORTLAND
State: OR
PostalCode: 972394501
CountryCode: US
TelephoneNumber: 5034941775
FaxNumber: 5034944749
Other Information
ProviderEnumerationDate: 05/02/2017
LastUpdateDate: 01/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X95006540CAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
363LA2100X202113223NP-PPORY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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