Krystal Ann Fillmore

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C5456 Issued in OR

Practice address

4455 NE Highway 20
Corvallis, OR 97330-9695

Phone

(541) 758-5900

NPI assigned

Feb 23, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: krystal.fillmore.1@33573.direct.athenahealth.com

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1073810321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023371",
            "telephone_number": "503-234-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 NE HIGHWAY 20",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973309695",
            "telephone_number": "541-758-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Hines St SE Ste 190",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973021356",
            "country_code": "US",
            "telephone_number": "971-208-9249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FILLMORE",
        "first_name": "KRYSTAL",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C5456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Michael Field, RPH
• Stephanie Nichole Fields
• Miki Fifita
• Robin Lee Fifita
• Elizabeth Figa, D.O.
• Mallory Fillmore, PA-C
• M. Elizabeth Finch
• Kelly Lynore Rosenthal Fink, PMHNP-BC, FNP-C
• Brian M Finley, LMT
• Kathryn C Finley

• Professional Counselor in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.