Kelly C Yan, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202006258NP-PP Issued in OR

Practice address

1020 SW Taylor St. Suite 448
Portland, OR 97205-2509

Phone

(971) 300-4254

Fax

(503) 200-1241

NPI assigned

Feb 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2025 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Clinicops LLC

  • Internal Medicine Physician
  • Florence, OR
  • NPI 1497251268
  NPD (past)

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

{
    "created_epoch": "1582934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1255965166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SW TAYLOR ST STE 448",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052509",
            "telephone_number": "971-300-4254",
            "fax_number": "971-238-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SW TAYLOR ST. SUITE 448",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052509",
            "telephone_number": "971-300-4254",
            "fax_number": "503-200-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAN",
        "first_name": "KELLY",
        "middle_name": "C",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-29",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201809234RN",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202006258NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Yamauchi, M.D.
• Jennifer Yamin, LMFT INTERN
• Sonja Yamin, LMT
• Dan Min Yan, D.C.
• Esther Yan, LMT
• Kitty Yan, OTR/L
• Kyle Yan
• Michelle Yan, DSOM, LAC.
• Michelle Yan
• Lisa Rietz Yanase, MD

• 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 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.