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Contact Information

KRISTEN P MASSIMINO, MD
9155 SW BARNES RD STE 238
PORTLAND, OR97225-6629
 Phone: 503-216-6407
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Oncology

2086X0206X 02 Physician/General Surgery
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for KRISTEN P MASSIMINO · (Female)

NPI # 1720208556
Status Active
Credentials MD
Entity Individual
Enumeration date 04/26/2007
Last updated 03/22/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • OR License # MD171629
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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