Individual provider Active NPI

Laura D. Milner, PSY. D

  • Clinical Psychologist
  • Happy Valley, OR
National Provider Identifier
1144560582
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2332 Issued in OR
Practice address
11211 SE 82ND Ave
Suite O
Happy Valley, OR 97086-7624
Phone
(503) 722-6200
Fax
(503) 722-6545
NPI assigned
Feb 21, 2013
Last updated
Oct 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2332 OR Primary

Addresses

Primary practice location

11211 SE 82ND Ave
Suite O
Happy Valley, OR 97086-7624

Mailing address

2051 Kaen Rd
Suite 367
Oregon City, OR 97045-4035
Phone (503) 742-5300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmilner466555@oc.providencedirect.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20130503000228 OR Practitioner - Clinical Psychologist 9234376500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

5050 NE Hoyt St
Suite 240
Portland, OR 97213-2981
Phone (503) 215-6480

5330 NE Glisan St
Portland, OR 97213-3069

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2332ORMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Sep 22, 2014 Accepting new patients
Providence Health & Services Oregon CurrentSince Sep 22, 2014 Accepting new patients
County of Clackamas Office of County Auditor Past Accepting new patients

Locations

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

5050 NE Hoyt St
Ste 454
Portland, OR 97213
Phone (503) 215-6405

5330 NE Glisan St
Ste 100
Portland, OR 97213
Phone (503) 215-9700

Interoperability endpoints

  • Direct secure messaging: lmilner466555@oc.providencedirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1144560582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 KAEN RD",
            "address_2": "SUITE 367",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970454035",
            "telephone_number": "503-742-5300",
            "fax_number": "503-742-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 SE 82ND AVE",
            "address_2": "SUITE O",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "970867624",
            "telephone_number": "503-722-6200",
            "fax_number": "503-722-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILNER",
        "first_name": "LAURA",
        "middle_name": "D.",
        "credential": "PSY. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-21",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmilner466555@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "5330 NE Glisan St Ste 100",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972133069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Happy Valley, OR

Sources for this page

Verify at the official NPI Registry.