Eleven Eleven, Llc

LBN: Eleven Eleven, Llc
Eleven Eleven, Llc is an health care organization with primary practice located at 6714 Sw 62Nd Place , Portland OR 97219. The organization recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Art, Medical, which is considered as the primary health care specialty. Eleven Eleven, Llc can be contacted via phone (503) 956-9773, or through Berntsen, Erik via phone (503) 956-9773.

Contact Information

Primary practice address
6714 Sw 62Nd Place Portland OR 97219
Phone: (503) 956-9773
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Berntsen, Erik
Phone: (503) 956-9773

Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Art, Medical 246ZA2600X BAP-TA-10133461 Oregon

Profile Details

NPI number 1548667918
LBN Legal business name Eleven Eleven, Llc
DBA Doing business as
Authorized official Berntsen, Erik
Entity Organization
Organization subpart 1 No
Enumeration date Dec 1st, 2014
Last updated Dec 1st, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548667918 NPPES
Oregon Other 155097 CERTIFIED PERMANENT COSMETICS PROFESSIONAL

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