Clark Paul Rector, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3245 Issued in OR

Practice address

1700 NW Civic Dr
Gresham, OR 97030-3770

Phone

(503) 666-8832

Fax

(503) 669-8641

NPI assigned

Sep 9, 2012

Last updated

May 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Western Psychological and Counseling Services LLCGroup PAC ID 7719975085, 331 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• WA PPO C-SNP
• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

• Direct secure messaging: lifestancehealth.clarkrector@148835.advancedmd-direct.com

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

• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Tacoma, WA
  • NPI 1912008178

  Addiction (Substance Use Disorder), OR

  Medicare reassignment Care Compare group NPD
• Western Psychological and Counseling Services LLC

  dba LifeStance Health

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1629345731
  NPD

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

{
    "created_epoch": "1347148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1063761716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 DURANT AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041725",
            "telephone_number": "707-494-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NW CIVIC DR",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303770",
            "telephone_number": "503-666-8832",
            "fax_number": "503-669-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RECTOR",
        "first_name": "CLARK",
        "middle_name": "PAUL",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-09",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Rathbun, CSWA, CADC-I
• Angie Agnes Rawley, DMD
• Salina Ray
• Monique Reina Reagan, PA-C
• Rebecca M Herrin Lac PC
• Lauren Noelle Reddy, MS, BCBA, LBA
• Noelle Redmond, PHARMD
• Patricia Jean Regan, MS, RD, CD, LD
• Regency Gresham Nursing & Rehabilitation Center LLC (Regency Gresham Nursing & Rehabilitation Center)
• Vicki J Reichlein, DMD

• Psychologist in Gresham, OR
• Providers in Gresham, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2020; 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.

Verify at the official NPI Registry.