Individual provider Active NPI

Caroline Keziah Thiongo

  • Psychiatric/Mental Health Nurse Practitioner
  • Clackamas, OR
National Provider Identifier
1063287837
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10021621 Issued in OR
Practice address
12360 SE Sunnyside Rd
Clackamas, OR 97015-9320
Phone
(503) 303-4000
Fax
(503) 344-4412
NPI assigned
Nov 21, 2023
Last updated
May 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10021621 OR Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61645300 WA
Psychiatric/Mental Health Registered Nurse 163WP0808X 298740 AZ

Addresses

Primary practice location

12360 SE Sunnyside Rd
Clackamas, OR 97015-9320

Mailing address

21155 E Duncan St
Queen Creek, AZ 85142-6763
Phone (972) 302-1431

Other practice location 1

412 E Southern Ave
Tempe, AZ 85282-5212
Phone (972) 302-1431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240826003654 OR Practitioner - Nurse Practitioner 5193264893 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cascadia HealthGroup PAC ID 7618873761, 53 clinicians

Practice addresses (Care Compare)

847 NE 19TH Ave
Suite 100
Portland, OR 97232-2684
Phone (502) 238-0769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
298740AZMDPsychiatric/Mental Health Registered Nurse
10021621ORMDPsychiatric/Mental Health Nurse Practitioner
AP61645300WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Health CurrentSince Aug 19, 2024 Accepting new patients
Thrive Psychological Wellness LLC Single Specialty CurrentSince May 23, 2025 Accepting new patients
Cascadia Health Single Specialty Current Accepting new patients
Cascade Counseling and Consulting LLC Single Specialty CurrentSince Dec 21, 2024 Accepting new patients

Locations

12360 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 303-4000

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

4304 SE 182nd Ave
Gresham, OR 97030
Phone (469) 396-5980

5441 S Macadam Ave
Ste R
Portland, OR 97239
Phone (818) 618-3619

707 NW Everett St
Portland, OR 97209
Phone (503) 222-4906

847 NE 19th Ave
Ste 100
Portland, OR 97232
Phone (503) 552-6203

1800 Blankenship Rd
Ste 448
West Linn, OR 97068
Phone (503) 929-7722

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1063287837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21155 E DUNCAN ST",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426763",
            "telephone_number": "972-302-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12360 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159320",
            "telephone_number": "503-303-4000",
            "fax_number": "503-344-4412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 E Southern Ave",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852825212",
            "country_code": "US",
            "telephone_number": "972-302-1431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIONGO",
        "first_name": "CAROLINE",
        "middle_name": "KEZIAH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10021621",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61645300",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "298740",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.