NPIMap

Organization Active NPI

Robert W McLellarn, PHD

  • Cognitive & Behavioral Psychologist
  • Portland, OR
National Provider Identifier
1174813539
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
634 Issued in OR
Legal business name
ROBERT W MCLELLARN, PHD
Practice address
5440 SW Westgate Drive
Suite 175
Portland, OR 97221
Phone
(971) 645-0033
Fax
(503) 297-5744
NPI assigned
Apr 19, 2011
Last updated
Apr 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Authorized official

Name
Dr. Robert William McLellarn, PHDNPI 1811009517
Title
Director
Phone
(971) 645-0033

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
Cognitive & Behavioral PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TB0200X 634 OR Primary

Addresses

Primary practice location

5440 SW Westgate Drive
Suite 175
Portland, OR 97221

Mailing address

5440 SW Westgate Drive
Suite 175
Portland, OR 97221
Phone (971) 645-0033

National Provider Directory

National Provider Directory

Locations

5440 SW Westgate Dr
Ste 175
Portland, OR 97221
Phone (503) 297-3334

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1303171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1174813539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 SW WESTGATE DRIVE",
            "address_2": "SUITE 175",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97221",
            "telephone_number": "971-645-0033",
            "fax_number": "503-297-5744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 SW WESTGATE DRIVE",
            "address_2": "SUITE 175",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97221",
            "telephone_number": "971-645-0033",
            "fax_number": "503-297-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT W MCLELLARN, PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-19",
        "last_updated": "2015-04-03",
        "status": "A",
        "authorized_official_last_name": "MCLELLARN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "971-645-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "OR",
            "license": "634",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 3, 2015; 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.