Individual provider Active NPI

Krista Kaufman, FNP

  • Family Nurse Practitioner
  • Portland, OR
National Provider Identifier
1447893383
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
201907058NP-PP Issued in OR
Practice address
1200 NE Broadway St Ste 20
Portland, OR 97232-1260
Phone
(971) 432-7555
NPI assigned
Oct 23, 2019
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP61328203 WA
Family Nurse Practitioner 363LF0000X 201907058NP-PP OR Primary

Addresses

Primary practice location

1200 NE Broadway St Ste 20
Portland, OR 97232-1260

Mailing address

PO Box 4825
Portland, OR 97208-4825
Phone (360) 882-2778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200205002492 OR Practitioner - Nurse Practitioner 2961838206 Reassigns benefits to 2 organizations
I20220726001732 WA Practitioner - Nurse Practitioner 2961838206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

340 NW Burnside Rd
Gresham, OR 97030-3852
Phone (360) 882-2778

700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201907058NP-PPORMDFamily Nurse Practitioner
AP61328203WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multnomah County CurrentSince Dec 31, 2019 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince May 23, 2022 Accepting new patients
Multnomah County Current Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Jul 7, 2022 Accepting new patients
Multnomah County CurrentSince Dec 31, 2019 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince May 23, 2022 Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

340 NW Burnside Rd
Gresham, OR 97030
Phone (971) 432-7500

600 NE 8th St
Gresham, OR 97030
Phone (503) 988-4900

1200 NE Broadway St
Ste 20
Portland, OR 97232
Phone (971) 432-7555

12710 SE Division St
Portland, OR 97236
Phone (503) 988-3410

209 SW 4th Ave
Ste 210
Portland, OR 97204
Phone (503) 988-3674

619 NW 6th Ave
Portland, OR 97209
Phone (503) 988-3674

619 NW 6th Ave
Fl 5
Portland, OR 97209
Phone (503) 988-5558

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

Interoperability endpoints

  • Direct secure messaging: kkaufman19520@tvc-direct.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1447893383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4825",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084825",
            "telephone_number": "360-882-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NE BROADWAY ST STE 20",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321260",
            "telephone_number": "971-432-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "KRISTA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61328203",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201907058NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.