Kimberly Wisotzke

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

Practice address

5440 SW Westgate Dr
Ste 175
Portland, OR 97221-2420

Phone

(971) 231-5519

NPI assigned

Nov 7, 2013

Sex

Female

Sole proprietor

No

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 Philosophy

Practice roles

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.

• Robert W McLellarn, PHD

  • Cognitive & Behavioral Psychologist
  • Portland, OR
  • NPI 1174813539
  NPD (past)

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426118400000",
    "number": "1336578665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 SW WESTGATE DR",
            "address_2": "STE 175",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212420",
            "telephone_number": "971-231-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 SW WESTGATE DR",
            "address_2": "STE 175",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212420",
            "telephone_number": "971-231-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISOTZKE",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2015-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Wisher, LMT
• Lindsey Joann Wismer, NP
• Anneke Jan Wisner
• Heather Wisner
• Karen Leigh Wisner, MPT
• Vanessa Rose Wissler
• Joanna Wiszniewska, M.D.
• Wojciech Krzysztof Wiszniewski, M.D.
• Kelly Witbeck, DNP, ARNP
• Leanne Michelle Witek, RD

• Cognitive & Behavioral Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Cognitive & Behavioral Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; 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.