Healthcare Provider Details

I. General information

NPI: 1609605849
Provider Name (Legal Business Name): ADARA KADIA JADE LANNING DNP, PMHNP, APRN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1547 NE 40TH AVE
PORTLAND OR
97232-1862
US

IV. Provider business mailing address

1547 NE 40TH AVE
PORTLAND OR
97232-1862
US

V. Phone/Fax

Practice location:
  • Phone: 541-621-5786
  • Fax:
Mailing address:
  • Phone: 541-621-5786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP70049823
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10050825
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: