Kyle Edward Anderson, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Beaverton, OR
NPI 1912540980 · NPPES record last updated Dec 16, 2025
Key facts
- NPI
- 1912540980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 202007455NP-PP (OR)
- Practice address
- 12655 SW Center St Ste 150
Beaverton, OR 97005-1864 - Phone
- (503) 832-0945
- NPI assigned
- Oct 23, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 202007455NP-PP | OR | MD | Psychiatric/Mental Health Nurse Practitioner |
| AP143637 | TX | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychiatrist on-Call, LLC | Past |
Accepting new patients |
Interoperability endpoints
- kyle.anderson.p1@direct.sokya.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP143637 | TX | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 202007455NP-PP | OR | Yes |
Addresses
Primary practice location
12655 SW Center St Ste 150
Beaverton, OR 97005-1864
Mailing address
1410 NE 106TH Ave
Portland, OR 97220-3934
Phone (210) 289-5953
Other providers in Beaverton, OR
- Christopher Anderson
- Gretchan Anderson
- Helen Marie Anderson
- Hope Anderson
- Jack Anderson
- Mark Alan Anderson
- Matthew Davis Anderson
- Megan Marie Anderson
- Scott H Anderson
- Tovi Marit Anderson
All providers in Beaverton, OR · Psychiatric/Mental Health 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 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.