Active NPI
Cynthia Polance Psychology
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1164042636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- CYNTHIA POLANCE PSYCHOLOGY
- Practice address
- 7912 SW 35TH Ave Ste 3
Portland, OR 97219-2427 - Phone
- (503) 278-4970
- Fax
- (503) 447-6640
- NPI assigned
- Apr 24, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cynthia Polance, PSYD
- Title
- Owner
- Phone
- (503) 869-4040
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary |
Addresses
Primary practice location
7912 SW 35TH Ave Ste 3
Portland, OR 97219-2427
Mailing address
8125 SW Ruby Ter
Portland, OR 97219-4649
Phone (503) 869-4040
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500770354 | Medicaid | OR |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.identillect.com |
National Provider Directory
National Provider DirectoryLocations
7912 SW 35th Ave
Ste 3
Portland, OR 97219
Phone (503) 278-4970
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": "1587686400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745884800000",
"number": "1164042636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8125 SW RUBY TER",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972194649",
"telephone_number": "503-869-4040",
"fax_number": "503-447-6640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7912 SW 35TH AVE STE 3",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972192427",
"telephone_number": "503-278-4970",
"fax_number": "503-447-6640"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CYNTHIA POLANCE PSYCHOLOGY",
"organizational_subpart": "NO",
"enumeration_date": "2020-04-24",
"last_updated": "2025-04-29",
"certification_date": "2025-04-29",
"status": "A",
"authorized_official_last_name": "POLANCE",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "503-869-4040",
"authorized_official_credential": "PSYD"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500770354",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.identillect.com",
"affiliation": "N",
"address_1": "7912 SW 35th Ave Ste 3",
"city": "Portland",
"state": "OR",
"country_code": "US",
"postal_code": "972192427",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.