Krysta St Michell, MEDICAL STUDENT

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

PG224993 Issued in OR

Practice address

2730 SW Moody Avenue Portland, Or
Portland, OR 97201

Phone

(541) 510-3165

NPI assigned

Jul 7, 2022

Sex

Female

Sole proprietor

No

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

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1700519550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 SW MOODY AVENUE PORTLAND, OR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 SW MOODY AVENUE PORTLAND, OR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97201",
            "telephone_number": "541-510-3165"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "890 Oak St SE",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973013905",
            "country_code": "US",
            "telephone_number": "541-510-3165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST MICHELL",
        "first_name": "KRYSTA",
        "credential": "MEDICAL STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "PG224993",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Johns Dental Arts PC
• Margaret M St Louis, RDH
• Claire Elizabeth St Marie
• Jamie D St Mark, CRNA
• St Mary Health LLC
• Kelsey Jordan St. Amand, PA-C, MPH
• St. Andrews Memory Care
• Jenna Lea St. Arnauld
• Leland St. Charles, PSY.D.
• Amanda St. Clair

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.