MEDICARE: KIMANI PSYCHIATRY

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1558223990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIMANI PSYCHIATRY

Provider Business Mailing Address
First Line	:	261 W VALENTINO ST
Second Line	:
City	:	MERIDIAN
State	:	ID
Zip	:	83646-6403
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2616 NE NOVA AVE
Second Line	:
City	:	HILLSBORO
State	:	OR
Zip	:	97124-2685
Country	:	US
Telephone Number	:	253-227-0018
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	STELLA KIMANI
Credential	:
Telephone Number	:	253-227-0018

Provider Enumeration Date	:	11/24/2025
Last Update Date	:	03/16/2026

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Directions to “KIMANI PSYCHIATRY ” Practice Location

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