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NPI Code Detail

MEDICARE: MS. KARIN LYNN NYSTROM

MEDICARE: MS. KARIN LYNN NYSTROM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist16939OR

General Provider Information

NPI Number : 1083549687
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KARIN LYNN NYSTROM
Provider Business Mailing Address
First Line : 4912 SE GRANT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97215-3837
Country : US
Telephone Number : 503-442-3214
Fax Number :
Provider Business Practice Location Address
First Line : 1511 DIVISION ST
Second Line :
City : OREGON CITY
State : OR
Zip : 97045-1588
Country : US
Telephone Number : 503-657-6747
Fax Number : 503-650-6324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “ MS. KARIN LYNN NYSTROM ” Practice Location

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