Provider Demographics
NPI:1447140173
Name:DAYTON, KRISTIN NICOLE
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:NICOLE
Last Name:DAYTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9022 SW 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-4824
Mailing Address - Country:US
Mailing Address - Phone:971-425-2272
Mailing Address - Fax:
Practice Address - Street 1:9022 SW 5TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-4824
Practice Address - Country:US
Practice Address - Phone:971-425-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-04
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR874453Medicaid