KALON A HENSON
Complete NPI Record 1568923571
Behavior Technician in Portland, OR

NPI Status: Active since March 31, 2019

Contact Information

9115 SW OLESON RD
PORTLAND, OR
ZIP 97223
Phone: (510) 328-7178

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Complete NPI Dataset

This page represents the complete record for NPI 1568923571. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1568923571
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Entity Type Code: 1
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider First Name: KALON
Provider Middle Name: A
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider First Line Business Mailing Address: 3720 SE 28TH PL APT 19
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider Business Mailing Address City Name: PORTLAND
Provider Business Mailing Address State Name: OR
Provider Business Mailing Address Postal Code: 972023048
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Country Code If outside U S : US
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Telephone Number: 2146039872
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider First Line Business Practice Location Address: 9115 SW OLESON RD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: PORTLAND
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: OR
The city name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code: 972236875
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 5103287178
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 3/31/2019
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 4/1/2019
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 106S00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No