Kristin Komorowski Wanlin, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

T1350 Issued in OR

Practice address

887 NW Grant Ave
Corvallis, OR 97330-4539

Phone

(541) 868-2004

NPI assigned

Jul 21, 2008

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

Other names 1

• Kristin Ann Komorowski Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Transformative Health and Wellness

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Corvallis, OR
  • NPI 1972246502
  Medicare reassignment NPD

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651622400000",
    "number": "1861657694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E 10TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013380",
            "telephone_number": "541-868-2004",
            "fax_number": "541-868-2003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 NW GRANT AVE",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973304539",
            "telephone_number": "541-868-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANLIN",
        "first_name": "KRISTIN",
        "middle_name": "KOMOROWSKI",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2022-05-04",
        "certification_date": "2022-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "98703",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "T1350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "KOMOROWSKI",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bo Wang, MD
• Natalie Yeu Wang, M.D.
• Rong Wang, M.D.
• Weijia Wang, M.D
• Ashley Elizabeth Wanless
• Kelly Ward, RN
• Lynn Gunby Ward, R.N.
• Ricky Allen Warf, DMD
• Jeremy Ross Warner, D.O.
• Paige Kimberly Warner, PHD

• Marriage & Family Therapist in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Marriage & Family Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2022; 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.