Active NPI
Emily Catherine Stasko, MPH, PHD
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1093373631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3175
- Practice address
- 3700 N Williams Ave
Portland, OR 97227-1441 - Phone
- (503) 281-4852
- NPI assigned
- May 29, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | TBD | OR | |
| Health Psychologist | 103TH0004X | TBD | OR | |
| Health Service Psychologist | 103TH0100X | TBD | OR | |
| Clinical Psychologist | 103TC0700X | 3175 | OR | Primary |
Addresses
Primary practice location
3700 N Williams Ave
Portland, OR 97227-1441
Mailing address
1950 NW Raleigh St Apt 201
Portland, OR 97209-1775
Phone (215) 827-9878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 20, 2025 through Nov 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3175 | OR | MD | Clinical Psychologist |
| TBD | OR | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737072000000",
"number": "1093373631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 NW RALEIGH ST APT 201",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972091775",
"telephone_number": "215-827-9878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3700 N WILLIAMS AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271441",
"telephone_number": "503-281-4852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STASKO",
"first_name": "EMILY",
"middle_name": "CATHERINE",
"name_prefix": "Dr.",
"credential": "MPH, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-29",
"last_updated": "2025-01-17",
"certification_date": "2025-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "TBD",
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "OR",
"license": "TBD",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "OR",
"license": "TBD",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "3175",
"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 Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.