Individual provider · Type 1 NPI
Elliott Louis Koivisto, NP
Psychiatric/Mental Health Nurse Practitioner · Tigard, OR
NPI number
1407592397
Active
Practice location
7145 SW Varns St Ste 206
Tigard, OR 97223-8168
Fax (800) 785-4531
Mailing address
11785 SW Robbins Dr
Beaverton, OR 97008-7949
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 10005745 (OR) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP61377025 (WA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1407592397
Elliott Louis Koivisto, NP's National Provider Identifier is 1407592397, issued on May 12, 2022. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Tigard, OR. The record was last updated on Nov 7, 2025.