Individual provider Active NPI

Jacquiline Mugure Kariuki

  • Psychiatric/Mental Health Nurse Practitioner
  • Portland, OR
National Provider Identifier
1629722848
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
10004365 Issued in OR
Practice address
10373 NE Hancock St Ste 200
Portland, OR 97220-3873
Phone
(503) 253-6754
Fax
(503) 253-8020
NPI assigned
Feb 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN274590 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 10004365 OR Primary

Addresses

Primary practice location

10373 NE Hancock St Ste 200
Portland, OR 97220-3873

Mailing address

PO Box 8459
Portland, OR 97207-8459
Phone (603) 238-0769

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240430002978 OR Practitioner - Nurse Practitioner 9436599057 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cascadia HealthGroup PAC ID 7618873761, 53 clinicians
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

10373 NE Hancock St
Suite 200
Portland, OR 97220-3873
Phone (503) 253-6754

11740 SW 68TH Pkwy
Suite 200
Tigard, OR 97223-9058
Phone (971) 352-6984

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN274590MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Health CurrentSince Apr 17, 2024 Accepting new patients
Cascadia Health CurrentSince Apr 17, 2024 Accepting new patients
Mindful Therapy Group PC Psychiatric/Mental Health CurrentSince Mar 28, 2024 Accepting new patients

Locations

10373 NE Hancock St
Ste 200
Portland, OR 97220
Phone (503) 253-6754

5440 SW Westgate Dr
Ste 350
Portland, OR 97221
Phone (503) 292-1100

707 NW Everett St
Portland, OR 97209
Phone (503) 222-4906

11740 SW 68th Pkwy
Ste 200
Tigard, OR 97223
Phone (425) 477-4216

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1644192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1629722848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8459",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972078459",
            "telephone_number": "603-238-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10373 NE HANCOCK ST STE 200",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972203873",
            "telephone_number": "503-253-6754",
            "fax_number": "503-253-8020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARIUKI",
        "first_name": "JACQUILINE",
        "middle_name": "MUGURE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-07",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN274590",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "10004365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.