Individual provider Active NPI

Kristin Molina, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1215599303
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
202104212NP-PP Issued in OR
Practice address
10373 NE Hancock St Ste 200
Portland, OR 97220-3873
Phone
(503) 253-6754
Fax
(503) 253-8020
NPI assigned
Jun 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 204835 LA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202104212NP-PP OR Primary

Addresses

Primary practice location

10373 NE Hancock St Ste 200
Portland, OR 97220-3873

Mailing address

PO Box 8459
Portland, OR 97207-8459
Phone (503) 238-0769

Other practice location 1

200 Henry Clay Ave
New Orleans, LA 70118-5720
Phone (504) 896-7200

Other names 1

  • Kristin Nielsen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
204835LAMDPsychiatric/Mental Health Nurse Practitioner
202104212NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Health CurrentSince Aug 23, 2021 Accepting new patients
Cascadia Health Current Accepting new patients

Locations

10373 NE Hancock St
Ste 200
Portland, OR 97220
Phone (503) 253-6754

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

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

3036 NE Mlk Jr Blvd
Portland, OR 97212
Phone (503) 283-3763

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": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1215599303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "503-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10373 NE HANCOCK ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203873",
            "telephone_number": "503-253-6754",
            "fax_number": "503-253-8020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Henry Clay Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701185720",
            "country_code": "US",
            "telephone_number": "504-896-7200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "LA",
            "license": "204835",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202104212NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "NIELSEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.