Active NPI
David Michael Corey, PH.D., ABPP
- Forensic Psychologist
- Lake Oswego, OR
National Provider Identifier
1104909894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 1187
- Practice address
- 5285 Meadows Road
Suite 311
Lake Oswego, OR 97035-3367 - Phone
- (503) 620-8050
- Fax
- (503) 620-9650
- NPI assigned
- Oct 24, 2006
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | 1187 | OR | Primary |
| Forensic Psychologist | 103TF0200X | PY-1941 | WA | |
| Forensic Psychologist | 103TF0200X | PSY-847 | HI | |
| Forensic Psychologist | 103TF0200X | PSY-11389 | CA | |
| Forensic Psychologist | 103TF0200X | 6271762-2501 | UT |
Addresses
Primary practice location
5285 Meadows Road
Suite 311
Lake Oswego, OR 97035-3367
Mailing address
PO Box 895
Lake Oswego, OR 97034-0143
Phone (503) 620-8050
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-11389 | CA | MD | Forensic Psychologist |
| PSY-847 | HI | MD | Forensic Psychologist |
| 6271762-2501 | UT | MD | Forensic Psychologist |
| PY-1941 | WA | MD | Forensic Psychologist |
| 1187 | OR | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104909894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 895",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970340143",
"telephone_number": "503-620-8050",
"fax_number": "503-620-9650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5285 MEADOWS ROAD",
"address_2": "SUITE 311",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970353367",
"telephone_number": "503-620-8050",
"fax_number": "503-620-9650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COREY",
"first_name": "DAVID",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PH.D., ABPP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "OR",
"license": "1187",
"primary": true
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "WA",
"license": "PY-1941",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "HI",
"license": "PSY-847",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "CA",
"license": "PSY-11389",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "UT",
"license": "6271762-2501",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Oswego, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.