Individual provider Active NPI

Krista Lynn Gautsche, LCSW

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1073812996
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L6037 Issued in OR
Practice address
2525 NW Lovejoy St
Portland, OR 97210-2859
Phone
(503) 563-3420
Fax
(971) 209-7262
NPI assigned
Mar 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X L6037 OR Primary
Mental Health Counselor 101YM0800X
Addiction (Substance Use Disorder) Counselor 101YA0400X OR

Addresses

Primary practice location

2525 NW Lovejoy St
Portland, OR 97210-2859

Mailing address

916 SW King Ave Ste 206
Portland, OR 97205-1332
Phone (503) 841-8678

Other practice location 1

916 SW King Ave Ste 206
Portland, OR 97205-1332
Phone (503) 841-8678

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140211000874 OR Practitioner - Clinical Social Worker 1951530153 Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2727 NE Siskiyou St
Portland, OR 97212-2558

916 SW King Ave
Suite 206
Portland, OR 97205-1332
Phone (971) 380-9179

PO Box
Suite 8459
Portland, OR 97207-8459

PO Box
Suite 9
Tillamook, OR 97141-0009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Mental Health CurrentSince Jun 1, 2014 Accepting new patients
Western Psychological and Counseling Services LLC Addiction (Substance Use Disorder) CurrentSince Jun 1, 2014 Accepting new patients

Locations

890 82nd Dr
Gladstone, OR 97027
Phone (503) 659-5515

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

870 82nd Dr
Gladstone, OR 97027
Phone (503) 272-8031

1700 NW Civic Dr
Ste 310
Gresham, OR 97030
Phone (503) 666-8832

3500 NE Mlk Jr Blvd
Ste 200
Portland, OR 97212
Phone (503) 327-8205

2525 NW Lovejoy St
Ste 204
Portland, OR 97210
Phone (503) 563-3420

18765 SW Boones Ferry Rd
Ste 100
Tualatin, OR 97062
Phone (503) 612-1000

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.kristagautsche@148835.advancedmd-direct.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1073812996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 SW KING AVE STE 206",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972051332",
            "telephone_number": "503-841-8678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NW LOVEJOY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102859",
            "telephone_number": "503-563-3420",
            "fax_number": "971-209-7262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "916 SW King Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972051332",
            "country_code": "US",
            "telephone_number": "503-841-8678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAUTSCHE",
        "first_name": "KRISTA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-17",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L6037",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.