Active NPI
Kaylin Jones, PH.D.
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1033637202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2874
- Practice address
- 1235 SE Division Street, Suite 115
Portland, OR 97202-9720 - Phone
- (503) 928-6346
- Fax
- (844) 364-7112
- NPI assigned
- Sep 7, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2874 | OR | Primary |
Addresses
Primary practice location
1235 SE Division Street, Suite 115
Portland, OR 97202-9720
Mailing address
1235 SE Division St Ste 115
Portland, OR 97202-1085
Phone (503) 928-6346
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2874 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504742400000",
"number": "1033637202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1235 SE DIVISION ST STE 115",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972021085",
"telephone_number": "503-928-6346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 SE DIVISION STREET, SUITE 115",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972029720",
"telephone_number": "503-928-6346",
"fax_number": "844-364-7112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "KAYLIN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-07",
"last_updated": "2017-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "2874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.