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Contact Information

KRISTIN R STEVENS, MD
417 SW 117TH AVE
SUITE 210
PORTLAND, OR97225-5924
 Phone: 503-216-9400
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for KRISTIN R STEVENS · (Female)

NPI # 1689690737
Status Active
Credentials MD
Entity Individual
Enumeration date 07/14/2006
Last updated 12/22/2021 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • OR License # MD24617
  • OR Medicaid 227482
  • OR Other P00078476 RR MEDICARE
Hospital affiliation(s)
  • PROVIDENCE PORTLAND MEDICAL CENTER - (Acute Care)
    4805 NE GLISAN STREET
    PORTLAND, OR 97213
  • PROVIDENCE ST VINCENT MEDICAL CENTER - (Acute Care)
    9205 SW BARNES ROAD
    PORTLAND, OR 97225
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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