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General NPI Number Information
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NPI Number | 1275496499
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Entity Type | Individual
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Provider Name | KRISTIN BEGG REVELL
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Gender | Female
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 6801 SE 60TH AVE
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City | PORTLAND
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State | OR
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Zip | 97206-7520
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Country | US
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Telephone | 503-916-5817
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Fax |
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Provider Business Mailing Address
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Address Line | 6678 SW 23RD PL
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City | PORTLAND
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State | OR
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Zip | 97219-5569
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 201142998RN
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License Number State | OR
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