Christina Marie Kucera, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L5820 Issued in OR

Practice address

4827 NE Campaign St
Portland, OR 97218-1732

Phone

(971) 212-0589

NPI assigned

Jan 26, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1548460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1487118170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4827 NE CAMPAIGN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181732",
            "telephone_number": "971-212-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4827 NE CAMPAIGN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972181732",
            "telephone_number": "971-212-0589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCERA",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-26",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L5820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/interconnect-prodnwm/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4827 NE Campaign St",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972181732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Forrest Kublick, PSY.D.
• Laura; Kubly
• Natsuki Kubotera, PHARMD
• Cobalt Jace Kubu
• Ryan Steve Kucala, OD
• Kevin Edward Kucharski, MD
• Arun Kuchela, MD
• Jarrod S Kucherak, MSN, APRN, FNP-C
• Kamini Kuchinad
• Andrea Kuchler

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.