Healthcare Provider Details

I. General information

NPI: 1265048151
Provider Name (Legal Business Name): CHRISTINA MARIE O'GUINN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 NE HALSEY ST STE 102
PORTLAND OR
97213-1545
US

IV. Provider business mailing address

4701 WARNER AVE APT 122
HUNTINGTON BEACH CA
92649-5044
US

V. Phone/Fax

Practice location:
  • Phone: 503-962-1000
  • Fax:
Mailing address:
  • Phone: 714-319-4124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95015358
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10022327
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: