Provider Demographics
NPI:1518972918
Name:TASKER, KRISTI LYNN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:LYNN
Last Name:TASKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KRISTI
Other - Middle Name:LYNN
Other - Last Name:SEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:8555 SW APPLE WAY STE 320
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-1775
Mailing Address - Country:US
Mailing Address - Phone:503-298-4592
Mailing Address - Fax:619-383-6701
Practice Address - Street 1:8555 SW APPLE WAY STE 320
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-1775
Practice Address - Country:US
Practice Address - Phone:503-298-4592
Practice Address - Fax:619-383-6701
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0580571104100000X
ORL32591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0000WDBCHOtherMEDICARE GROUP
OR164936Medicaid