Deborah Kay Pack-Patton, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2252 Issued in OR

Practice address

5329 NE Martin Luther King Jr Blvd
Portland, OR 97211-3237

Phone

(503) 988-5183

Fax

(503) 988-5182

NPI assigned

Sep 13, 2011

Last updated

Jan 3, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451779200000",
    "number": "1164704433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15823 NE 19TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986844517",
            "telephone_number": "503-657-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5329 NE MARTIN LUTHER KING JR BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972113237",
            "telephone_number": "503-988-5183",
            "fax_number": "503-988-5182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACK-PATTON",
        "first_name": "DEBORAH",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-13",
        "last_updated": "2016-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22959",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Wellness Group, LLC
• Pacifica Calaroga Terrace LLC (Pacifica Senior Living Calaroga)
• Eric Louis Pacini, MD
• Lisa Pacioretty, LMT
• Lucia Paciotti, PT, DPT
• Amber Packard, L.M.T.
• Daniel N Packard, DO
• Darren John Packard, SLP
• Linda Dee Packard, L.P.C.
• Christine Packett Buchiarelli, LAC

• Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2016; 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.