Individual provider Active NPI

Teresa Burnelle Keirns, RN, CNM

  • Advanced Practice Midwife
  • Portland, OR
National Provider Identifier
1114231016
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
201601564NP-PP Issued in OR
Practice address
3727 NE Martin Luther King Jr Blvd
Portland, OR 97212-1112
Phone
(888) 875-7820
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 1904 CA
Registered Nurse 163W00000X 730310 CA
Advanced Practice Midwife 367A00000X AP60670307 WA
Advanced Practice Midwife 367A00000X 201601564NP-PP OR Primary

Addresses

Primary practice location

3727 NE Martin Luther King Jr Blvd
Portland, OR 97212-1112

Mailing address

4750 SE Robin Rd
Milwaukie, OR 97267-3121
Phone (401) 225-6167

Other practice location 1

2800 N Vancouver Ave Ste 255
Portland, OR 97227-1671
Phone (503) 413-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190218002236 WA Practitioner - Certified Nurse Midwife (CNM) 6608061288 Reassigns benefits to 2 organizations
I20190301001649 OR Practitioner - Certified Nurse Midwife (CNM) 6608061288 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Registered Nurse

State licenses

LicenseStateTypeSpecialty
730310CAMDRegistered Nurse
1904CAMDOccupational Therapy Assistant
201601564NP-PPORMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 9, 2019 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 9, 2019 Accepting new patients
Legacy Clinics LLC Midwife CurrentSince Nov 7, 2021 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Jan 9, 2019 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Oct 7, 2025 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Oct 7, 2025 Accepting new patients
Planned Parenthood of the Columbia/Willamette, Inc. Past Accepting new patients
Legacy Emanuel Hospital & Health Center Past Accepting new patients
Kaiser Foundation Hospitals Past Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

2800 N Vancouver Ave
Portland, OR 97227
Phone (503) 413-4340

2800 N Vancouver Ave
Ste 255
Portland, OR 97227
Phone (503) 413-4500

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: tkeirns761161@direct.lhs.org

Organizations & group practices 9

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": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1114231016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 SE ROBIN RD",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972673121",
            "telephone_number": "401-225-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3727 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121112",
            "telephone_number": "888-875-7820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 N Vancouver Ave Ste 255",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271671",
            "country_code": "US",
            "telephone_number": "503-413-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEIRNS",
        "first_name": "TERESA",
        "middle_name": "BURNELLE",
        "credential": "RN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1904",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "730310",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP60670307",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "201601564NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.