Tracy Marie Jendritza, PSY D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1631 Issued in OR

Practice address

5200 SW Macadam Ave
# 580
Portland, OR 97239-6103

Phone

(503) 231-7854

Fax

(503) 231-8153

NPI assigned

May 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tracy Marie McDonald Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Portland Dialectical Behavior Therapy PC

  • Cognitive & Behavioral Psychologist
  • Portland, OR
  • NPI 1619913787
  NPD (past)

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1063470987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 SW MACADAM AVE",
            "address_2": "# 580",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396103",
            "telephone_number": "503-231-7854",
            "fax_number": "503-231-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 SW MACADAM AVE",
            "address_2": "# 580",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396103",
            "telephone_number": "503-231-7854",
            "fax_number": "503-231-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENDRITZA",
        "first_name": "TRACY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "MCDONALD",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Margaret Ak Jelinski, MA
• Jonathan Jelmini, DDS, MD
• Jen Conjerti Acupuncture
• Maria Jen, OD
• Morene Jen
• John W Jendrzejewski, MD
• Joanne Jene, MD
• Cathy D Jenkins-Naze, LCSW
• Alex K Jenkins, MD
• Alexandra Antonia Jenkins

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.