Beaverton Psychology Services LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

811 Issued in OR

Legal business name

BEAVERTON PSYCHOLOGY SERVICES LLC

Practice address

16110 SW Regatta LN
Beaverton, OR 97006-8942

Phone

(503) 526-2917

NPI assigned

Apr 26, 2011

Last updated

Dec 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Terri Lynn Mishler, PSYDNPI 1639109895

Title

Manager

Phone

(503) 526-2917

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Terri Lynn Mishler, PSYD

  • Psychologist
  • Beaverton, OR
  • NPI 1639109895
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1083905996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16110 SW REGATTA LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068942",
            "telephone_number": "503-526-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16110 SW REGATTA LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068942",
            "telephone_number": "503-526-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVERTON PSYCHOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-26",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "MISHLER",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-526-2917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.