Active NPI
David Windstrom, PSY D
- Psychologist
- Tigard, OR
National Provider Identifier
1063505063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1702
- Practice address
- 6950 SW Hampton St
Ste. 218
Tigard, OR 97223-8329 - Phone
- (503) 972-8957
- NPI assigned
- Oct 2, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1702 | OR | Primary |
Addresses
Primary practice location
6950 SW Hampton St
Ste. 218
Tigard, OR 97223-8329
Mailing address
9220 SW Barbur Blvd
Ste 119-241
Portland, OR 97219-5428
Phone (503) 972-8957
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8942728 | Other | WA | CRIME VICTIMS |
| 838736000 | Other | OR | REGENCE BLUECROSS |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386720000000",
"number": "1063505063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9220 SW BARBUR BLVD",
"address_2": "STE 119-241",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972195428",
"telephone_number": "503-972-8957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6950 SW HAMPTON ST",
"address_2": "STE. 218",
"city": "TIGARD",
"state": "OR",
"postal_code": "972238329",
"telephone_number": "503-972-8957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINDSTROM",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "PSY D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2013-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "1702",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS",
"identifier": "8942728",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUECROSS",
"identifier": "838736000",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tigard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.