Mary Bogle

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20469 Issued in CA

Practice address

520 SW 6TH Ave
Ste 830
Portland, OR 97204-1514

Phone

(530) 917-8877

Fax

(530) 245-9222

NPI assigned

Mar 6, 2007

Sex

Female

Sole proprietor

Yes

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mary Bogle Psy D LLC

  • Clinical Psychologist
  • Milwaukie, OR
  • NPI 1881325892
  Medicare reassignment NPD Authorized official
• Milwaukie Chiropractic & Massage Clinic, PC

  • Clinic/Center
  • Milwaukie, OR
  • NPI 1891981999
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1083744536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SW 6TH AVE",
            "address_2": "STE 830",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041514",
            "telephone_number": "530-917-8877",
            "fax_number": "530-245-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SW 6TH AVE",
            "address_2": "STE 830",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041514",
            "telephone_number": "530-917-8877",
            "fax_number": "530-245-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGLE",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "20469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robyn Sue Bogden, PT
• Elizabeth Mary Bogdon, MA
• Haley Katherine Boge
• Elisa Boggs
• Elsie Bogle, MSW, CSWA
• Marta Bogrand, OTL
• Taylor Boham, ND
• Cynthia Ann Bohan, PAC
• Robert Alexander Bohanan
• Kathleen Bohanna, RN

• 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 Dec 3, 2019; 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.