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

Individual provider Internal Medicine Physician · NPI 1700519550

Krysta St Michell, MEDICALSTUDENT is an Internal Medicine Physician in Portland, Oregon. Works from 2 locations. Licensed in Oregon.

Licensed in
OR
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

2730 SW Moody Avenue Portland OR
Portland, OR 97201
Phone: (541) 510-3165
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 890 Oak St Se, Salem, OR 97301-3905 — (541) 510-3165

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence PG224993 (OR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1700519550
Entity typeIndividual (Type 1)
GenderFemale
Credentials MEDICALSTUDENT
Sole proprietorNo
NPI enumeratedJuly 7, 2022
Last updated in NPPESAugust 25, 2025
Certification dateAugust 25, 2025
Mailing address2730 Sw Moody Avenue Portland, Or, Portland, OR 97201

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