Organization · Type 2 NPI
Illumina Integrative Psychiatry
Psychiatric/Mental Health Nurse Practitioner · Portland, OR
NPI number
1932067139
Active
Practice location
1109 NE Prescott St
Portland, OR 97211-4659
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counseling Psychologist | 103TC1900X | None listed |
| Health & Wellness Coach | 171400000X | None listed |
| Nurse Practitioner | 363L00000X | None listed |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1932067139
Illumina Integrative Psychiatry's National Provider Identifier is 1932067139, issued on Jan 14, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Portland, OR. The record was last updated on Jan 14, 2026.