Active NPI
Christie Kesserwani
- Psychiatry Physician
- Portland, OR
National Provider Identifier
1942655295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- DO204293
- Practice address
- 3181 SW Sam Jackson Park Rd, Uhn 80
Portland, OR 97239 - Phone
- (503) 494-0065
- NPI assigned
- Apr 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 007418 | AZ | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | DO204293 | OR | Primary |
Addresses
Primary practice location
3181 SW Sam Jackson Park Rd, Uhn 80
Portland, OR 97239
Mailing address
3181 SW Sam Jackson Park Rd, Uhn 80
Portland, OR 97239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007418 | AZ | MD | Psychiatry Physician |
| DO204293 | OR | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692230400000",
"number": "1942655295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD, UHN 80",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3181 SW SAM JACKSON PARK RD, UHN 80",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-494-0065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KESSERWANI",
"first_name": "CHRISTIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-24",
"last_updated": "2023-08-17",
"certification_date": "2023-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AZ",
"license": "007418",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OR",
"license": "DO204293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.