Individual provider Active NPI

Rowan Schuitevoerder, PSY.D

  • Psychologist
  • Portland, OR
National Provider Identifier
1285193557
Registry record updated Mar 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3033 Issued in OR
Practice address
2049 NW Hoyt St
Portland, OR 97209-1260
Phone
(503) 459-6020
NPI assigned
Mar 17, 2019
Last updated
Mar 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3033 OR Primary

Addresses

Primary practice location

2049 NW Hoyt St
Portland, OR 97209-1260

Mailing address

4630 SW 39TH Dr
Portland, OR 97221-3923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3033ORMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1552780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552780800000",
    "number": "1285193557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 SW 39TH DR",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972213923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2049 NW HOYT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091260",
            "telephone_number": "503-459-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUITEVOERDER",
        "first_name": "ROWAN",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-17",
        "last_updated": "2019-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.