Provider Demographics
NPI:1174678270
Name:SLATER, KRISTI MARIE (ND, QMHP)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:MARIE
Last Name:SLATER
Suffix:
Gender:F
Credentials:ND, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6114 S KELLY AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3612
Mailing Address - Country:US
Mailing Address - Phone:503-810-7471
Mailing Address - Fax:
Practice Address - Street 1:6114 S KELLY AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3612
Practice Address - Country:US
Practice Address - Phone:503-810-7471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2025-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3094175F00000X, 175F00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171M00000XOther Service ProvidersCase Manager/Care Coordinator