Active NPI
Tawayne Nolen Malone Jr.
- Psychologist
- Portland, OR
National Provider Identifier
1083130991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 0615 SW Palatine Hill Road
Tawayne Malone - MSC 2159
Portland, OR 97219 - Phone
- (916) 868-5787
- NPI assigned
- Aug 22, 2017
- 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 | Primary |
Addresses
Primary practice location
0615 SW Palatine Hill Road
Tawayne Malone - MSC 2159
Portland, OR 97219
Mailing address
0615 SW Palatine Hill Road
Tawayne Malone - MSC 2159
Portland, OR 97219
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503360000000",
"number": "1083130991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "0615 SW PALATINE HILL ROAD",
"address_2": "TAWAYNE MALONE - MSC 2159",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "0615 SW PALATINE HILL ROAD",
"address_2": "TAWAYNE MALONE - MSC 2159",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97219",
"telephone_number": "916-868-5787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALONE",
"first_name": "TAWAYNE",
"middle_name": "NOLEN",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-22",
"last_updated": "2017-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"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 Aug 22, 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.