Individual provider Active NPI

Kara Marie Joll, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1194525329
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
200540138RN Issued in OR
Practice address
905 SE 14TH Ave
Portland, OR 97214-2569
Phone
(503) 622-8964
Fax
(971) 339-4913
NPI assigned
Mar 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 200540138RN OR Primary

Addresses

Primary practice location

905 SE 14TH Ave
Portland, OR 97214-2569

Mailing address

905 SE 14TH Ave
Portland, OR 97214-2569
Phone (503) 622-8964

Other practice location 1

9045 NW Egret St
Seal Rock, OR 97376-9645
Phone (541) 961-8753

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
I20250724000573 OR Practitioner - Nurse Practitioner 2567978612 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200540138RNORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Larsen Sanchez Psychology, LLC CurrentSince Aug 18, 2025 Accepting new patients

Locations

812 SW Washington St
Ste 700
Portland, OR 97205
Phone (503) 622-8964

905 SE 14th Ave
Portland, OR 97214
Phone (503) 622-8964

Organizations & group practices 1

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": "1742169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1194525329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SE 14TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142569",
            "telephone_number": "503-622-8964",
            "fax_number": "971-339-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SE 14TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142569",
            "telephone_number": "503-622-8964",
            "fax_number": "971-339-4913"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9045 NW Egret St",
            "address_purpose": "LOCATION",
            "city": "Seal Rock",
            "state": "OR",
            "postal_code": "973769645",
            "country_code": "US",
            "telephone_number": "541-961-8753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOLL",
        "first_name": "KARA",
        "middle_name": "MARIE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-17",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "200540138RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.