Individual provider Active NPI

Karen Dimalanta, PH.D.

  • Clinical Psychologist
  • Tigard, OR
National Provider Identifier
1215026406
Registry record updated Aug 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1469 Issued in OR
Practice address
7455 SW Beveland
Tigard, OR 97223
Phone
(503) 624-2600
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2007

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 1469 OR Primary

Addresses

Primary practice location

7455 SW Beveland
Tigard, OR 97223

Mailing address

P.O. Box 82819
Portland, OR 97282
Phone (503) 624-2600

Other identifiers 1

IdentifierTypeStateIssuer
164936MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211110001753 OR Practitioner - Clinical Psychologist 1254720311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychological Services Connection LLCGroup PAC ID 7416317789, 15 clinicians

Practice addresses (Care Compare)

811 SW 6TH Ave
Suite 1000
Portland, OR 97204-1345
Phone (503) 334-3035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1469ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Services Connection LLC CurrentSince Jul 1, 2024 Accepting new patients

Locations

9400 SW Beaverton Hillsdale Hwy
Ste 250
Beaverton, OR 97005
Phone (503) 743-7456

811 SW 6th Ave
Ste 1000
Portland, OR 97204
Phone (503) 334-3035

Interoperability endpoints

  • Direct secure messaging: karen.dimalanta.p1@direct.sokya.nextgenshare.com
  • Direct secure messaging: lifestancehealth.karendimalanta@148835.advancedmd-direct.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188086400000",
    "number": "1215026406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 82819",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97282",
            "telephone_number": "503-624-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7455 SW BEVELAND",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "97223",
            "telephone_number": "503-624-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMALANTA",
        "first_name": "KAREN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164936",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.