Kristine Kae Hanna, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1961 Issued in OR

Practice address

530 1St St Ste B
Lake Oswego, OR 97034-3248

Phone

(503) 680-3958

NPI assigned

Nov 2, 2010

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

Other names 1

• Kristy K Hanna Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2016 through Apr 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288656000000",
    "number": "1497055792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 1ST ST STE B",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343248",
            "telephone_number": "503-680-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 1ST ST STE B",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343248",
            "telephone_number": "503-680-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "KRISTINE",
        "middle_name": "KAE",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "HANNA",
            "middle_name": "K",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jee Young Han, DMD
• Kari Hancock, MD
• Hand Surgery Associates Northwest
• Hands of Gold, LLC
• John D Hanna, DDS
• Taylor Genevieve Hansen
• Emily Hanson, PT, DPT
• Walter Ray Hardin, D.O.
• Joan Mary Hardy, L.P.C.
• Adrienne Elyse Harmon, PMHNP

• Clinical Psychologist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.