Soroush Mohandessi, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD126173 Issued in OR

Practice address

833 SW 11TH Ave Ste 214
Portland, OR 97205-2116

Phone

(503) 481-9441

Fax

(503) 224-5951

NPI assigned

Mar 11, 2008

Last updated

Jan 20, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Mohandessi Psych LLC

  • Psychiatry Physician
  • Vancouver, WA
  • NPI 1770157380
  Authorized official Same address or phone

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1285804799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE STE 214",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052116",
            "telephone_number": "503-481-9441",
            "fax_number": "503-224-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 SW 11TH AVE STE 214",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052116",
            "telephone_number": "503-481-9441",
            "fax_number": "503-224-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHANDESSI",
        "first_name": "SOROUSH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-11",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD126173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Imran A Mohamedy, MD
• Mitchka Mohammadi, MD, MS
• Shahrzad Mohammadi, PHARMD
• Sahra Mohamud
• Kerry Ellen Mohan
• Ajay Bharat Mohinani, DO
• Shanti I Mohling, MD
• Robert Luke Mohlman, LCSW
• Rory Mohon, LMT
• Danielle Corin Mohr, MS

• Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.