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MRS. KAY DIANE PETERSON PMHNP
NPI 1457367690
Nurse Practitioner - Community Health in Portland, OR

Active since July 31, 2006
412 SW 12TH AVE, PORTLAND, OR 97205(503) 228-7134(503) 944-2595 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mrs. Kay Diane Peterson Pmhnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KAY DIANE PETERSON PMHNP (NPI 1457367690) is an individual community health provider in Portland, Oregon, licensed in Oregon (093006731N6) and active in the NPI registry since July 2006.

NPPES Registry Identity

NPI1457367690
Entity TypeIndividualFemale
Primary Taxonomy363LC1500X
Provider Legal NameMRS. KAY DIANE PETERSONCredential: PMHNP
Location Address412 SW 12TH AVEPortland, OR 97205-2329
Mailing Address7056 Se Pine StPortland, OR 97215-1430 · (503) 255-6768
Phone(503) 228-7134
Fax(503) 944-2595
Sole ProprietorNo
Enumeration DateJuly 31, 2006
Last NPPES UpdateSeptember 11, 2025
✔ NPI 1457367690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Community HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LC1500X
License✔ Licensed in OR · 093006731N6
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License 093006731N6 (OR)
412 SW 12TH AVE, Portland, OR 97205
Open in Google Maps ↗

Other Identifiers 1

Medicaid069596OR

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. GREGORY S BELL QMHA
Case Manager/Care Coordinator
412 SW 12TH AVE
PORTLAND, OR 97205
Multnomah County (503) 228-7134
MR. JAMIE H GLEASON
Counselor (Mental Health)
412 SW 12TH AVE
PORTLAND, OR 97205
Multnomah County (503) 228-7134
MS. ELIZABETH SCHEELER KIMBERLY
Social Worker (Clinical)
412 SW 12TH AVE
PORTLAND, OR 97205
Multnomah County (503) 228-7134
MR. RODERICK J ROBINSON QMHA
Social Worker (Clinical)
412 SW 12TH AVE
PORTLAND, OR 97205
Multnomah County (503) 228-7134
JAMES M. WRIGHT QMHA
Case Manager/Care Coordinator
412 SW 12TH AVE
PORTLAND, OR 97205
Multnomah County (503) 516-2048
DONALD BENJAMIN KUNZER BA
Adult Companion
412 SW 12TH AVE
PORTLAND, OR 97205
Multnomah County (503) 228-7134
ANNALISA COUTURIER
Counselor (Addiction (Substance Use Disorder))
412 SW 12TH AVE
PORTLAND, OR 97205
Multnomah County (503) 228-7134
MS. FRANNY RACHEL THOMPSON QMHP, MSW
Social Worker (Clinical)
412 SW 12TH AVE
PORTLAND, OR 97205
Multnomah County (503) 552-0769

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kay Peterson's NPI number?

The NPI number for Kay Peterson is 1457367690. It was assigned to this individual provider in the NPPES registry on July 31, 2006.

Where is Kay Peterson located?

Kay Peterson practices at 412 SW 12th Ave, Portland, OR 97205. The listed phone number is (503) 228-7134.

What is Kay Peterson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Community Health, with taxonomy code 363LC1500X.

When was this NPI record last updated?

The NPPES record for Kay Peterson was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.