Individual provider Active NPI

Rachel A Kvamme Jones, PSYD

  • Clinical Psychologist
  • Lake Oswego, OR
National Provider Identifier
1003080284
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2605 Issued in OR
Practice address
4004 Kruse Way PL Ste 300
Lake Oswego, OR 97035-2479
Phone
(503) 216-1500
NPI assigned
Apr 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2605 OR Primary

Addresses

Primary practice location

4004 Kruse Way PL Ste 300
Lake Oswego, OR 97035-2479

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 216-1500

Other names 1

  • Rachel A Kvamme Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rkvammejones554445@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151204000682 OR Practitioner - Clinical Psychologist 3779883285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

4004 Kruse Way PL
Suite 300
Lake Oswego, OR 97035-2479
Phone (503) 216-1500

5050 NE Hoyt St
Suite 454
Portland, OR 97213-2984
Phone (503) 215-6405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Oregon Current Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 16, 2015 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Oregon Health and Science University Past Accepting new patients

Locations

440 NW Division St
Gresham, OR 97030
Phone (503) 215-9500

4004 Kruse Way Pl
Ste 300
Lake Oswego, OR 97035
Phone (503) 216-1500

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

5211 NE Glisan St
Bldg C
Portland, OR 97213
Phone (503) 215-3081

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

Interoperability endpoints

  • Direct secure messaging: rkvammejones554445@oc.providencedirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1003080284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-216-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 KRUSE WAY PL STE 300",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352479",
            "telephone_number": "503-216-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "RACHEL",
        "middle_name": "A KVAMME",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkvammejones554445@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "4004 Kruse Way Pl Ste 300",
            "city": "Lake Oswego",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970352479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "KVAMME",
            "middle_name": "A",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.