Kristina Michelle Leidich, FNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

201911095NP-PP Issued in OR

Practice address

18633 SE Stark St Ste 401
Portland, OR 97233-5468

Phone

(503) 489-1760

NPI assigned

Jan 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristina Michelle Leidich Professional name

Medicare fee-for-service enrollment

Enrolled in OR

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 1

Specialty

Family Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Wallace Medical ConcernGroup PAC ID 2365680865, shared by 2 NPIs, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: kacord277509@direct.ochin.org

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.

• The Wallace Medical Concern

  dba Wallace

  • Federally Qualified Health Center (FQHC)
  • Portland, OR
  • NPI 1841592110
  Medicare reassignment

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

{
    "created_epoch": "1578528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1619517406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18738 SE GRANT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335518",
            "telephone_number": "541-499-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18633 SE STARK ST STE 401",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335468",
            "telephone_number": "503-489-1760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIDICH",
        "first_name": "KRISTINA",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-09",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "201911095NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "LEIDICH",
            "middle_name": "MICHELLE",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Stephanie Leichner
• Alexandra Leichter, LCSW
• Joseph Allen Leick
• Michael Leidecker, PSYD
• Ryan Leiderman
• Rom Samuel Leidner, MD
• Leigh K Lewis ND Lac LLC
• Leigh Kochan Lewis, N.D, L.Ac.
• Jamie Leigh, LCSW
• Janet Marilyn Leigh, MD

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.