Active NPI
Andrew E Bliesner, PSY.D.
- Clinical Psychologist
- Lake Oswego, OR
National Provider Identifier
1245570605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2536
- Practice address
- 14523 Westlake Dr Ste a
Lake Oswego, OR 97035-7700 - Phone
- (503) 984-7353
- Fax
- (503) 372-9094
- NPI assigned
- Feb 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2536 | OR | Primary |
Addresses
Primary practice location
14523 Westlake Dr Ste a
Lake Oswego, OR 97035-7700
Mailing address
14523 Westlake Dr Ste a
Lake Oswego, OR 97035-7700
Phone (503) 984-7353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 8, 2023 through Nov 8, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2536 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479081600000",
"number": "1245570605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14523 WESTLAKE DR STE A",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970357700",
"telephone_number": "503-984-7353",
"fax_number": "503-372-9094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14523 WESTLAKE DR STE A",
"city": "LAKE OSWEGO",
"state": "OR",
"postal_code": "970357700",
"telephone_number": "503-984-7353",
"fax_number": "503-372-9094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLIESNER",
"first_name": "ANDREW",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-02-22",
"last_updated": "2016-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "2536",
"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 Nov 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.