Individual provider Active NPI

Patrick Ethel-King, PH.D.

  • Clinical Psychologist
  • Beaverton, OR
National Provider Identifier
1205982709
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1615 Issued in OR
Practice address
8880 SW Nimbus Ave Ste C
Beaverton, OR 97008-7111
Phone
(503) 352-0240
Fax
(971) 279-5635
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1615 OR Primary

Addresses

Primary practice location

8880 SW Nimbus Ave Ste C
Beaverton, OR 97008-7111

Mailing address

1675 SW Marlow Ave
Ste. 301
Portland, OR 97225-5104
Phone (503) 352-0240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1615ORMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1205982709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 SW MARLOW AVE",
            "address_2": "STE. 301",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972255104",
            "telephone_number": "503-352-0240",
            "fax_number": "503-352-0242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 SW NIMBUS AVE STE C",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087111",
            "telephone_number": "503-352-0240",
            "fax_number": "971-279-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHEL-KING",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2026; 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.