KRISTIN R STEVENS (NPI# 1689690737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689690737 |
| Entity Type | Individual |
| Full Name | KRISTIN R STEVENS |
| Credential | MD |
| Practice Address |
417 Sw 117th Ave Suite 210 Portland OR 97225-5924 |
| Mailing Address |
Po Box 3158 Portland OR 97208-3158 |
| Practice Telephone | 5032169400 |
| Mailing Telephone | 5032156494 |
| Mailing Fax Number | 5032156644 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2013-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | MD24617 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | RR MEDICARE | P00078476 | 01 |
| OR | 227482 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144532318 | Kristin Stevens | Dentist | 5873 N State Road 135, Greenwood, IN 46143-5616 | 2010-07-05 |
| 1811034333 | Kristin Elizabeth Stevens | Speech-Language Pathologist | 1835 Paradise Ridge Dr, Round Rock, TX 78664-5628 | 2007-01-31 |
| 1245255454 | Kristin Brook Stevens | Registered Nurse | 404 N Cayuga Street, Ithaca, NY 14850-4219 | 2006-07-12 |
| 1780661413 | Kristin A Stevens | General Practice | Box 357051 Nasni, Comnavairfor, San Diego, CA 92135-7051 | 2005-12-23 |
| 1962882696 | Kristin Stevens | Nurse Practitioner | 401 Carlson Pkwy, Mail Route Cp340, Minnetonka, MN 55305-5359 | 2015-06-08 |
| 1033598669 | Kristin Leanne Stevens | Student in an Organized Health Care Education/Training Program | 420 Delaware St Se, Mmc 396, Minneapolis, MN 55455-0341 | 2015-05-28 |
| 1518208412 | Kristin Nicole Stevens | Case Manager/Care Coordinator | 50 Vantage Point Dr Ste 4, Rochester, NY 14624-1180 | 2013-03-04 |
| 1164661898 | Kristin E. Stevens | Massage Therapist | 16923 96th Ave Ne, Bothell, WA 98011-1937 | 2009-02-19 |
| 1982654752 | Kristin Marie Stevens | Pediatrics | 6465 S Yale Ave, Suite 715, Tulsa, OK 74136-7822 | 2006-05-11 |
| Street Address |
417 SW 117TH AVE SUITE 210 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588666432 | Myrna Antonio Casono | Internal Medicine | 417 Sw 117th Ave, Portland, OR 97225-5924 | 2005-08-11 |
| 1871065649 | Kathryn Elise Burk | Physician Assistant | 417 Sw 117th Ave, Portland, OR 97225-5924 | 2018-12-18 |
| 1447736608 | Jonathan Ryan Fordyce | Nurse Practitioner | 417 Sw 117th Ave, Portland, OR 97225-5924 | 2018-07-11 |
| 1609206036 | Nicole Knigge | Physician Assistant | 417 Sw 117th Ave, 2nd Floor, Portland, OR 97225-5924 | 2013-11-21 |
| 1669801387 | Karen Ann Ballard | Nurse Practitioner | 417 Sw 117th Ave, Suite 100, Portland, OR 97225-5924 | 2013-11-04 |
| 1043648330 | Yvonne Howell | Physician Assistant | 417 Sw 117th Ave, Suite 200, Portland, OR 97225-5924 | 2013-10-23 |
| 1528250131 | Megan Lear Mudrick | Family Medicine | 417 Sw 117th Ave, Suite 100, Portland, OR 97225-5924 | 2007-08-16 |
| 1346450319 | Jean D Lee | Internal Medicine | 417 Sw 117th Ave, 2nd Floor, Portland, OR 97225-5924 | 2007-05-22 |
| 1376680918 | Connie Volpi | Physician Assistant | 417 Sw 117th Ave, 2nd Floor, Portland, OR 97225-5924 | 2007-01-31 |
| 1154408151 | Michael R. Mcclung Md | Clinic/Center | 417 Sw 117th Ave, Ste. 120, Portland, OR 97225-5924 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508303561 | Carter Kroeplin Haag | Dermatology | 3303 S Bond Ave # 16d, Portland, OR 97239-4501 | 2017-01-27 |
| 1043765134 | Noelle Teske | Dermatology | 3303 S Bond Ave Fl 16, Portland, OR 97239-4501 | 2016-08-18 |
| 1134579535 | Caroline Morris | Dermatology | 3303 S Bond Ave # Chh16d, Portland, OR 97239-4501 | 2016-06-16 |
| 1033539184 | Natasha Fewkes Carter | Dermatology | 4914 Sw 1st Ave, Portland, OR 97239-2883 | 2014-04-16 |
| 1538588504 | Elizabeth Berry | Dermatology | Ohsu Department of Dermatology, 3303 Sw Bond Ave Ch 16d, Portland, OR 97239-4501 | 2014-04-07 |
| 1124250584 | Einar Axel Juhlin | Dermatology | 340 Eastern Promenade, Unit 154, Portland, ME 04101-2754 | 2009-08-19 |
| 1902040777 | Rajan P Kulkarni | Dermatology | 3303 Sw Bond Ave Ste 16, Portland, OR 97239 | 2009-04-23 |
| 1124280540 | Omar N Qutub | Dermatology | 1129 Nw 11th Ave, Portland, OR 97209-3469 | 2008-06-26 |
| 1285891168 | Stacy Nicole Reed | Dermatology | 13305 Nw Cornell Rd Ste C, Portland, OR 97229-5987 | 2008-05-19 |
| 1427243591 | Robert Bickford Amon | Dermatology | 1700 Sw Broadway Dr, Portland, OR 97201-2211 | 2007-09-11 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.