Kristen Bender, NP
Individual provider Active NPI Nurse Practitioner · Portland, OR
NPI 1851023451 · NPPES record last updated Dec 15, 2023
Key facts
- NPI
- 1851023451
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 10010027 (OR)
- Practice address
- 1700 NE 102ND Ave
Portland, OR 97220-3804 - Phone
- (971) 917-5455
- NPI assigned
- Jun 30, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA, OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230915002538 | WA | Practitioner - Nurse Practitioner | 6800250341 | Reassigns benefits to 1 organization |
| I20230921002056 | OR | Practitioner - Nurse Practitioner | 6800250341 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10010027 | OR | MD | Registered Nurse |
| RN60946246 | WA | MD | Registered Nurse |
| AP61462618 | WA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of the Northwest | Current |
Accepting new patients |
Locations
10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946
7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051
1700 NE 102nd Ave
Portland, OR 97220
Phone (866) 279-4581
2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400
1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801
7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | AP61462618 | WA | |
| Registered Nurse | 163W00000X | RN60946246 | WA | |
| Registered Nurse | 163W00000X | 10010027 | OR | |
| Nurse Practitioner | 363L00000X | 10010027 | OR | Yes |
Addresses
Primary practice location
1700 NE 102ND Ave
Portland, OR 97220-3804
Mailing address
4620 103Rd Ave SE
Olympia, WA 98513-8814
Phone (530) 949-0540
Other providers in Portland, OR
- Michael Ann Benchoff
- Alexandria Bender
- Christopher M Bender
- Elizabeth Bender
- Jan L Bender
- Mitchell Bender
- Shani Joy Bender
- Tina M Bender
- Bending Reed Counseling, LLC
- Olga Bendinger
All providers in Portland, OR · Nurse Practitioner in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.