Wellspring Psychiatry LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

WELLSPRING PSYCHIATRY LLC

Practice address

5 Centerpointe Dr Ste 400
Lake Oswego, OR 97035-8661

Phone

(503) 919-7682

NPI assigned

May 17, 2024

Organization subpart

No

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

Authorized official

Name

Jacob Kirkwood, PMHNPNPI 1700566585

Title

Owner

Phone

(503) 757-4209

Specialties & licenses 1

Addresses

Other names 1

• Wellspring Psychiatry Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacob Gabriel Kirkwood, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Happy Valley, OR
  • NPI 1700566585
  NPD Authorized official

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1336998616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR STE 400",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CENTERPOINTE DR STE 400",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358661",
            "telephone_number": "503-919-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-17",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "KIRKWOOD",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-757-4209",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellspring Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gregory Haylett Weidlich, D.C.
• Stephen Alan Weil, MD
• Brian Jeffrey Weiss, LMT
• Garen Leeann Weitman, PSY.D.
• Wellness Chiropractic Center
• Amanda Nicole Welton, RN
• Sue E Wendling, DMD
• Nancy Lee Wernecke, PMHNP
• Kylee Weron, MSW
• Marcus Dillon West

• Psychiatric/Mental Health Nurse Practitioner in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; 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.