Marsha Sharyn Cristales-Fontaine

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

C5676 Issued in OR

Practice address

1235 SE Division St
Portland, OR 97202-1099

Phone

(360) 726-4141

NPI assigned

Feb 19, 2014

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1609291269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12844 SW 132ND AVE",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972231750",
            "telephone_number": "971-317-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021099",
            "telephone_number": "360-726-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISTALES-FONTAINE",
        "first_name": "MARSHA",
        "middle_name": "SHARYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-19",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C5676",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF 75045",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sonja Charlene Crisosto, LCSW
• Kara Crisp, N.D.
• Kathy Ann Crispell, MD
• Julie A Crispin, L.M.T.
• Audrey A Crist, MD
• Regina Anne Cristan, INTERN
• Cristina L Rust DMD LLC
• Cynthia B Cristofani, MD
• Janelle Jean Cristofaro
• Carol Lipson Criswell

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.