Individual provider Active NPI

Kristine Mua, RN

  • Registered Nurse
  • Portland, OR
National Provider Identifier
1235093758
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
10039394 Issued in OR
Practice address
4104 SE 82ND Ave Ste 250
Portland, OR 97266-2954
Phone
(503) 215-9850
NPI assigned
Dec 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 10039394 OR Primary

Addresses

Primary practice location

4104 SE 82ND Ave Ste 250
Portland, OR 97266-2954

Mailing address

4104 SE 82ND Ave Ste 250
Portland, OR 97266-2954
Phone (503) 215-9850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
10039394ORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1765324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1235093758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4104 SE 82ND AVE STE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662954",
            "telephone_number": "503-215-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 SE 82ND AVE STE 250",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662954",
            "telephone_number": "503-215-9850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUA",
        "first_name": "KRISTINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-10",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "10039394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.