Transformational Healing: Rediscover Yourself LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

TRANSFORMATIONAL HEALING: REDISCOVER YOURSELF LLC

Practice address

555 SE Martin Luther King Jr Blvd Unit 105
Portland, OR 97214-2595

Phone

(971) 266-0177

Fax

(855) 631-0578

NPI assigned

Sep 26, 2025

Organization subpart

No

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

Authorized official

Name

Kristen Fernandez-Kong, DNP, PMHNP-BCNPI 1144714858

Title

Owner

Phone

(808) 388-6277

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristen Fernandez-Kong, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
  • NPI 1144714858
  NPD Authorized official

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

{
    "created_epoch": "1758844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758844800000",
    "number": "1255204129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 SE MARTIN LUTHER KING JR BLVD UNIT 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142595",
            "telephone_number": "971-266-0177",
            "fax_number": "855-631-0578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 SE MARTIN LUTHER KING JR BLVD UNIT 105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972142595",
            "telephone_number": "971-266-0177",
            "fax_number": "855-631-0578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRANSFORMATIONAL HEALING: REDISCOVER YOURSELF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-26",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-09",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ-KONG",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "808-388-6277",
        "authorized_official_credential": "DNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500745543",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.