Eleven Eleven, LLC
Specialist/Technologist, Other (Art, Medical)

Address: 6714 Sw 62nd Place, Portland, OR 97219
Phone: 5039569773

Eleven Eleven, LLC (NPI# 1548667918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1548667918
Entity Type Organization
Organization Name ELEVEN ELEVEN, LLC
Practice Address 6714 Sw 62nd Place
Portland
OR 97219
Practice Telephone 5039569773
Mailing Address 6714 Sw 62nd Place
Portland
OR 97219
Mailing Telephone 5039569773
Authorized Official Name Mr. Erik Berntsen (OWNER)
Authorized Official Telephone 5039569773
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2014-12-01
Last Update Date 2014-12-01

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 246ZA2600X Specialist/Technologist, Other · Art, Medical Technologists, Technicians & Other Technical Service Providers BAP-TA-10133461 OR

Other Provider Identifier

State Identifier Issuer Type Code
OR 155097 OTHER CERTIFIED PERMANENT COSMETICS PROFESSIONAL

Taxonomy Information

Taxonomy Code 246ZA2600X
Grouping Technologists, Technicians & Other Technical Service Providers
Classification Specialist/Technologist, Other
Specialization Art, Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1326445651 Erik Berntsen Specialist/Technologist, Other 1820 Sw Vermont St, Suite K, Portland, OR 97219-1945 2014-12-02
1164791992 Mary Jane Haake Specialist/Technologist, Other 1017 Sw Morrison St, 205, Portland, OR 97205-2635 2011-12-22

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Office Location

Street Address 6714 SW 62ND PLACE
City PORTLAND
State OR
Zip Code 97219

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1356958672 Lighthouse Psychological Services, LLC Psychologist 630 Sw Nevada St, Ste. E, Poralnd, OR 97219 2020-09-30
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1023414257 Paul Shayne Hansen Adult Companion 9155 Sw 55th Avenue, Portland, OR 97219 2014-11-17
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1255749404 Kristin Rae Paruszkiewicz Physical Therapist 7943 Sw Barbur Blvd #1, Portland, OR 97219 2014-07-31
1639436488 Michelle Lorraine Emery Counselor 7912 Sw 35th, Portland, OR 97219 2012-04-18
1588930192 Steve Ryan Speech-Language Pathologist 3315 Sw Falcon St, Portland, OR 97219 2012-03-28
1104145952 Multnomah Family Care Center Clinic/Center 6787 Sw Capitol Hwy, Portland, OR 97219 2010-05-19
1740518331 Trilbie L Patteson Physical Therapy Assistant 5701 Sw Multnomah Boulevard, West Hills Health and Rehab, Portland, OR 97219 2009-11-20
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Competitor

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City PORTLAND
Zip Code 97219

Improve Information

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Dataset Information

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.