Provider Demographics
NPI:1801133475
Name:ALDINGER, KELLY CHRISTINE (PMHNP-BC, MSW)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:CHRISTINE
Last Name:ALDINGER
Suffix:
Gender:
Credentials:PMHNP-BC, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1610
Mailing Address - Street 2:
Mailing Address - City:SCAPPOOSE
Mailing Address - State:OR
Mailing Address - Zip Code:97056-1610
Mailing Address - Country:US
Mailing Address - Phone:971-202-1122
Mailing Address - Fax:855-978-2666
Practice Address - Street 1:5200 MEADOWS RD STE 150
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-0066
Practice Address - Country:US
Practice Address - Phone:971-202-1122
Practice Address - Fax:855-978-2666
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60996510163WP0808X
OR202007291NP-PP363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health