Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Illumina Integrative Psychiatry

Organization Counseling Psychologist · NPI 1932067139

Illumina Integrative Psychiatry is a Counseling Psychologist in Portland, Oregon. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
4

Practice location Address checks out

1109 NE Prescott St
Portland, OR 97211-4659
Phone: (208) 696-8107
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X
Counseling Psychologist Taxonomy 103TC1900X
Health & Wellness Coach Taxonomy 171400000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1932067139
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Krista Miller — Owner · (208) 596-8107
NPI enumeratedJanuary 14, 2026
Last updated in NPPESJanuary 14, 2026
Certification dateJanuary 14, 2026
Mailing address1109 Ne Prescott St, Portland, OR 97211-4659

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