Kaseymichelle Qualman, DNP, MS-RN, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

202109196NP-PP Issued in OR

Practice address

6924 NE Sandy Blvd
Portland, OR 97213-5256

Phone

(503) 300-4111

NPI assigned

Mar 2, 2021

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kaseymichellecpnp@mvpkidscare.opdirect.net

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.

• Pacific Crest Childrens Urgent Care LLC

  • Urgent Care Clinic/Center
  • Portland, OR
  • NPI 1164947701
  NPD

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

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1326633397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6924 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972135256",
            "telephone_number": "503-300-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6924 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972135256",
            "telephone_number": "503-300-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALMAN",
        "first_name": "KASEYMICHELLE",
        "name_prefix": "Dr.",
        "credential": "DNP, MS-RN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "220689",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "202109196NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Quach, PHARM. D
• Anthony Quach
• Khoa Quach, D.O
• Mathias Quackenbush, MSW
• Caitlin Quaempts, MD
• Austin Quanbeck
• Eleanor Quandt, BA, QMHP
• Kathryn Quanstrom
• Brett Anthony Quarles, PAC
• Nicole Teresa Quarles

• Pediatric Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Pediatric Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.