Provider Demographics
NPI:1922631787
Name:SUMP, KARA (RN, QMHP-RN)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:
Last Name:SUMP
Suffix:
Gender:F
Credentials:RN, QMHP-RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 NE 2ND ST UNIT 133
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-4762
Mailing Address - Country:US
Mailing Address - Phone:503-714-6306
Mailing Address - Fax:
Practice Address - Street 1:1900 NE HIGHWAY 99W STE K
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-2757
Practice Address - Country:US
Practice Address - Phone:503-714-6306
Practice Address - Fax:503-472-4511
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200942164RN163WC0400X, 163WC1500X, 163WE0003X, 163WG0000X, 163WN0800X, 163WN1003X, 163WS0200X, 163WX0106X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WX0106XNursing Service ProvidersRegistered NurseOccupational Health