Individual provider Active NPI

Michael Brooke, PSY.D.

  • Clinical Psychologist
  • Vancouver, WA
National Provider Identifier
1275645061
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00003704 Issued in WA
Practice address
2101 NE 139TH St Ste 460
Vancouver, WA 98686-2325
Phone
(360) 487-2727
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1830 OR
Clinical Psychologist 103TC0700X PY00003704 WA Primary

Addresses

Primary practice location

2101 NE 139TH St Ste 460
Vancouver, WA 98686-2325

Mailing address

PO Box 2077
Portland, OR 97208-2077
Phone (503) 413-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091022000523 OR Practitioner - Clinical Psychologist 3072650118 Reassigns benefits to 1 organization
I20091022000548 WA Practitioner - Clinical Psychologist 3072650118 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Meridian Park HospitalGroup PAC ID 5092609842, 113 clinicians
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

19300 SW 65TH Ave
Tualatin, OR 97062-7706
Phone (503) 413-4330

2101 NE 139TH St
Suite 260
Vancouver, WA 98686-2311
Phone (360) 487-2870

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY00003704WAMDClinical Psychologist
1830ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Jul 30, 2024 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Jul 30, 2024 Accepting new patients
Department of Social Dept of SHS Div of Instns CurrentSince Jan 14, 2024 Accepting new patients
Brooke Psychologists, LLC Clinical Past Accepting new patients

Locations

1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

2101 NE 139th St
Ste 260
Vancouver, WA 98686
Phone (360) 487-2870

2101 NE 139th St
Ste 460
Vancouver, WA 98686
Phone (360) 487-2727

Organizations & group practices 5

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1275645061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2077",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082077",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NE 139TH ST STE 460",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862325",
            "telephone_number": "360-487-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKE",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1830",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00003704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.