Organization Active NPI

Oak & Fern Psychotherapy

  • Clinical Psychologist
  • Portland, OR
National Provider Identifier
1104662055
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
OAK & FERN PSYCHOTHERAPY
Practice address
9500 SW Barbur Blvd Ste 110
Portland, OR 97219-5425
Phone
(503) 884-6921
NPI assigned
Jul 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Nicholas Schollars, PSYD.NPI 1184281438
Title
Psychologist
Phone
(503) 884-6921

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

9500 SW Barbur Blvd Ste 110
Portland, OR 97219-5425

Mailing address

9500 SW Barbur Blvd Ste 110
Portland, OR 97219-5425
Phone (503) 910-6379

Other identifiers 1

IdentifierTypeStateIssuer
60054OtherORAETNA

National Provider Directory

National Provider Directory

Locations

5 Centerpointe Dr
Ste 400
Lake Oswego, OR 97035
Phone (503) 784-3489

9500 SW Barbur Blvd
Ste 110
Portland, OR 97219
Phone (503) 884-6921

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1104662055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 SW BARBUR BLVD STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972195425",
            "telephone_number": "503-910-6379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 SW BARBUR BLVD STE 110",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972195425",
            "telephone_number": "503-884-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK & FERN PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "SCHOLLARS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "503-884-6921",
        "authorized_official_credential": "PSYD."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "60054",
            "state": "OR"
        }
    ],
    "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 Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.