Active NPI
Amy Lynn Salazar, PSY.D.
- Clinical Psychologist
- Troutdale, OR
National Provider Identifier
1013925148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1867
- Practice address
- 107 E Historic Columbia River Hwy
Ste 208
Troutdale, OR 97060-2093 - Phone
- (503) 550-8587
- Fax
- (503) 491-8736
- NPI assigned
- Aug 4, 2006
- Last updated
- Dec 26, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY18300 | CA | |
| Clinical Psychologist | 103TC0700X | 1867 | OR | Primary |
Addresses
Primary practice location
107 E Historic Columbia River Hwy
Ste 208
Troutdale, OR 97060-2093
Mailing address
PO Box 1542
Gresham, OR 97030-0510
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090923000677 | OR | Practitioner - Clinical Psychologist | 1052338472 | Practice locations: Troutdale, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
107 E Historic Columbia River Hwy
Suite 208
Troutdale, OR 97060-2093
Phone (503) 550-8587
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1867 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514246400000",
"number": "1013925148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1542",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970300510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 E HISTORIC COLUMBIA RIVER HWY",
"address_2": "STE 208",
"city": "TROUTDALE",
"state": "OR",
"postal_code": "970602093",
"telephone_number": "503-550-8587",
"fax_number": "503-491-8736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALAZAR",
"first_name": "AMY",
"middle_name": "LYNN",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2017-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY18300",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Troutdale, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.