Individual provider Active NPI

Nathan William Engle, PSYD

  • Psychologist
  • Portland, OR
National Provider Identifier
1336481100
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2799 Issued in OR
Practice address
3530 SE 88TH Ave
Portland, OR 97266-2396
Phone
(503) 772-4335
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2799 OR Primary

Addresses

Primary practice location

3530 SE 88TH Ave
Portland, OR 97266-2396

Mailing address

3530 SE 88TH Ave
Portland, OR 97266-2396
Phone (503) 772-4335

Other identifiers 1

IdentifierTypeStateIssuer
500731842MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170919001351 OR Practitioner - Clinical Psychologist 3870867542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Farm Workers ClinicGroup PAC ID 4385541986, 274 clinicians

Practice addresses (Care Compare)

8935 SE Powell Blvd
Portland, OR 97266-1938
Phone (509) 865-6175

9047 SE Foster Rd
Portland, OR 97266-4617
Phone (509) 865-6175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2799ORMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Farm Workers Clinic Current Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Jan 2, 2024 Accepting new patients
Yakima Valley Farm Workers Clinic CurrentSince Jan 2, 2024 Accepting new patients

Locations

589 NW 11th St
Hermiston, OR 97838
Phone (503) 567-1717

3530 SE 88th Ave
Portland, OR 97266
Phone (503) 772-3999

8935 SE Powell Blvd
Portland, OR 97266
Phone (503) 349-7864

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1336481100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 SE 88TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662396",
            "telephone_number": "503-772-4335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 SE 88TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662396",
            "telephone_number": "503-772-4335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLE",
        "first_name": "NATHAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2799",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500731842",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.