Active NPI
Shagun Pawar, PSYD
- Clinical Psychologist
- Forest Grove, OR
National Provider Identifier
1275981763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3156
- Practice address
- 2043 College Way
Forest Grove, OR 97116-1756 - Phone
- (503) 352-6151
- NPI assigned
- May 25, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Psychologist | 103TC0700X | 3156 | OR | Primary |
Addresses
Primary practice location
2043 College Way
Forest Grove, OR 97116-1756
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494
Other practice location 1
265 SE Oak St
Hillsboro, OR 97123-4392
Phone (503) 215-2300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3156 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576195200000",
"number": "1275981763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "503-215-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2043 COLLEGE WAY",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "971161756",
"telephone_number": "503-352-6151"
}
],
"practiceLocations": [
{
"address_1": "265 SE Oak St",
"address_purpose": "LOCATION",
"city": "Hillsboro",
"state": "OR",
"postal_code": "971234392",
"country_code": "US",
"telephone_number": "503-215-2300",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PAWAR",
"first_name": "SHAGUN",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-25",
"last_updated": "2019-12-13",
"certification_date": "2019-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "3156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Grove, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2019; 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.