NPIMap

Organization Active NPI

Ricks Warren PH.D., Abpp, PC

  • Clinical Psychologist
  • Lake Oswego, OR
National Provider Identifier
1205023645
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
422 Issued in OR
Legal business name
RICKS WARREN PH.D., ABPP, PC
Practice address
4550 Kruse Way Ste 225
Lake Oswego, OR 97035-2586
Phone
(503) 635-8710
Fax
(503) 635-0583
NPI assigned
Oct 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Dr. Ricks Warren, PH.D.
Title
President
Phone
(503) 635-8710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 422 OR Primary

Addresses

Primary practice location

4550 Kruse Way Ste 225
Lake Oswego, OR 97035-2586

Mailing address

4550 S.W. Kruse Way #225
Lake Oswego, OR 97035
Phone (503) 635-8710

National Provider Directory

National Provider Directory

Locations

4550 Kruse Way
Ste 225
Lake Oswego, OR 97035
Phone (503) 635-8710

4550 Kruse Way
Ste 255
Lake Oswego, OR 97035
Phone (503) 635-8710

Practitioners & affiliated clinicians

Practitioners 7

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": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1205023645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 S.W. KRUSE WAY #225",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "97035",
            "telephone_number": "503-635-8710",
            "fax_number": "503-635-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 KRUSE WAY STE 225",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970352586",
            "telephone_number": "503-635-8710",
            "fax_number": "503-635-0583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICKS WARREN PH.D., ABPP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "RICKS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-635-8710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.