ELEVEN ELEVEN, LLC; NPI #1548667918

Contact Information

ELEVEN ELEVEN, LLC

6714 SW 62ND PLACE
PORTLAND, OR 97219

Phone: 503-956-9773
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Medical Art Specialist/Technologist	246ZA2600X

Indicates primary specialty

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NPI Profile & details for ELEVEN ELEVEN, LLC

NPI # 1548667918

LBN Legal business name ELEVEN ELEVEN, LLC

Authorized official ERIK BERNTSEN - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/01/2014

Last updated 12/01/2014 - About 12 years ago

Identifiers

OR	License #	BAP-TA-10133461
OR	Other	155097	CERTIFIED PERMANENT COSMETICS PROFESSIONAL

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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ELEVEN ELEVEN, LLC

Contact Information

Specialty

Medical Art Specialist/Technologist

NPI Profile & details for ELEVEN ELEVEN, LLC

Reviews for ELEVEN ELEVEN, LLC