Isabelle Raya Sanderson

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

025454 Issued in NY

Practice address

722 NE 162ND Ave
Portland, OR 97230-5760

Phone

(503) 341-4798

NPI assigned

Aug 24, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1194192302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305760",
            "telephone_number": "503-341-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "ISABELLE",
        "middle_name": "RAYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "025454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Sanders, CRM
• Nancy Elizabeth Sanders
• Tamara Patrice Sanders, RN
• Tamara Renee Sanderson Dissanayake, MD
• Dezirae Michelle Sanderson, RN
• Thomas David Sanderson, AGACNP
• Harpal Amarjeet Singh Sandhu, MD
• Coral Sandler
• David Sandler
• Grant Elliott Sandler

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

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