Provider Demographics
NPI:1386897809
Name:KLING, MARIA S (NP)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:S
Last Name:KLING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 92900
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97292-0900
Mailing Address - Country:US
Mailing Address - Phone:503-665-8176
Mailing Address - Fax:
Practice Address - Street 1:831 NW COUNCIL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3721
Practice Address - Country:US
Practice Address - Phone:503-665-8176
Practice Address - Fax:503-665-8178
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201393371NP-PP363LA2200X
CA18610363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0079700OtherMEDICAL GROUP
CAZZZ13858ZOtherGROUP MEDICARE
CA1316054737OtherGROUP NPI
CARN 557967OtherREGISTERED NURSE
CANP 18610OtherNURSE PRACTITIONER