Portage Bay Clinic

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PORTAGE BAY CLINIC

Practice address

4500 9TH Ave NE Ste 300
Seattle, WA 98105-4762

Phone

(206) 414-9322

NPI assigned

Apr 10, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Grant, PHDNPI 1396124012

Title

Owner/Practitioner

Phone

(206) 890-5040

Specialties & licenses 2

Addresses

Other names 2

• Jeffrey Arthur Grant Doing business as
• Portage Bay Psychotherapy Clinic Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Arthur Grant, PHD

  • Psychologist
  • Seattle, WA
  • NPI 1396124012
  NPD Authorized official

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

{
    "created_epoch": "1681084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1184319782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 9TH AVE NE STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054762",
            "telephone_number": "206-414-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 9TH AVE NE STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054762",
            "telephone_number": "206-414-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE BAY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-10",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "206-890-5040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jeffrey Arthur Grant",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Portage Bay Psychotherapy Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Kay Popplewell, ARNP
• Robin Anne Poppsinger, MA, LMHC
• Poppy Interventional Psychiatry
• Mariya Popruzhnyy
• Amy Portacci, D.O.
• Grete Hemmingsen Porteous, MD
• Andrea Gail Porter-Smith
• Anastasia L Porter, MD
• Bruce Arnold Porter, M.D., F.A.C.R.
• Christopher R Porter, MD

• Clinical Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.