Wildwood Psychiatric Resource Center

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

WILDWOOD PSYCHIATRIC RESOURCE CENTER

Practice address

16110 SW Regatta LN
Beaverton, OR 97006-8942

Phone

(503) 629-2131

Fax

(503) 617-9379

NPI assigned

May 16, 2006

Last updated

Jul 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ann J. Howard, MDNPI 1184647174

Title

President

Phone

(503) 690-8606

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ann Johnson Howard, MD

  • Psychiatry Physician
  • Beaverton, OR
  • NPI 1184647174
  Authorized official Same address or phone
• Katie A Ugolini, PHD

  • Psychologist
  • Beaverton, OR
  • NPI 1346267184
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248307200000",
    "number": "1235181868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 610",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "970240610",
            "telephone_number": "503-963-1221",
            "fax_number": "503-230-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16110 SW REGATTA LN",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970068942",
            "telephone_number": "503-629-2131",
            "fax_number": "503-617-9379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD PSYCHIATRIC RESOURCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2009-07-23",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-690-8606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "054123000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Payton Wilcox
• Wild Mountain Medicine LLC
• Wild Wish Counseling LLC
• Jonathan Douglas Wildi, M.D.
• Wildwood Health and Wellness
• Suzanne Wilhour
• Gerald Stanley Wilk Jr.
• Ashley Wilkins, LCSW
• Denise Wilkinson, O.D.
• Willamette Dental

• Psychologist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; 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.