Mrs. Kay Diane Peterson
PMHNP | Nurse Practitioner - Psych/Mental Health
412 Sw 12th Ave, Portland
Oregon, 97205-2329
503-228-7134
Mrs. Kay Diane Peterson is a Portland, Oregon based nurse practitioner who is specialized as Psych/Mental Health nurse. Active license number of Mrs. Kay Diane Peterson is 093006731N6 for Community Health in Oregon. Her current practice location is 412 Sw 12th Ave, Portland. Patients can reach her at 503-228-7134 or can fax her at 503-944-2595. Mrs. Kay Diane Peterson is PMHNP with specialization in Psych/Mental Health and her NPI number (Unique professional ID assigned by NPPES) is 1457367690.
Mrs. Kay Diane Peterson provides a full range of primary mental health care services, including biopsychosocial assessment and diagnosis of patients with mental illness and co-occurring disorders. Treatment modalities include both medication and psychotherapeutic management. Psych/Mental Health Nurse Practitioner (PMHNP) works in a variety of settings, including inpatient, emergency and community-based mental health services.
Complete Profile:
Mrs. Kay Diane Peterson speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Mrs. Kay Diane Peterson |
| Specialization: | Psych/Mental Health Nurse Practitioner (PMHNP) |
| Gender: | Female |
| Credentials: | PMHNP |
| Practice Address: | 412 Sw 12th Ave, Portland,
Oregon, 97205-2329 |
| Phone: | 503-228-7134 |
| Fax: | 503-944-2595 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1457367690 |
| NPI Enumeration Date: | 31 Jul, 2006 |
| NPI Last Update On: | 11 Sep, 2025 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mrs. Kay Diane Peterson are as mentioned below.
| License Number | Specialization | State | Status | |
| 093006731N6 | Community Health | Oregon | Primary | |
| 093006731N6 | Psych/Mental Health | Oregon | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Mrs. Kay Diane Peterson such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 069596 | Medicaid | Oregon | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Mrs. Kay Diane Peterson
7056 Se Pine St,
Portland, Oregon |
| Zip: | 97215-1430 |
| Phone Number: | 503-255-6768 |
Patients can reach Mrs. Kay Diane Peterson at
412 Sw 12th Ave, Portland, Oregon or can
call to book an appointment on 503-228-7134.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.