Individual
MISS KRISTIN LOIS CUMMINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5329 NE MARTIN LUTHER KING BLVD, PORTLAND, OR 97211-3237
(503) 988-5183
(503) 988-5182
Mailing address
421 SW OAK ST, STE. 210, PORTLAND, OR 97204-1817
(503) 988-7468
(503) 988-3015
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
201040123RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201250003NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022959
—
OR
05
—
096511
—
OR
Enumeration date
12/12/2007
Last updated
03/09/2017
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