1033270939 NPI number — MS. KAREN KAZZ A ARTIS LPC, LCAT

Table of content: MS. KAREN KAZZ A ARTIS LPC, LCAT (NPI 1033270939)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033270939 NPI number — MS. KAREN KAZZ A ARTIS LPC, LCAT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARTIS
Provider First Name:
KAREN KAZZ
Provider Middle Name:
A
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LPC, LCAT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033270939
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/20/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3801 SE TENINO ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97202-8041
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-774-3624
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
421 SW OAK ST
Provider Second Line Business Practice Location Address:
SUITE 520
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97204-1817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-988-3999
Provider Business Practice Location Address Fax Number:
503-988-3328
Provider Enumeration Date:
12/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 221700000X , with the licence number:  01-028 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 221700000X , with the licence number: ART-C-10206190 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: C3188 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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