John Robert Crossen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

703 Issued in OR

Practice address

4370 NE Halsey St
Suite 101
Portland, OR 97213-1543

Phone

(503) 220-1332

Fax

(503) 220-8531

NPI assigned

Sep 21, 2006

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

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.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346349925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4370 NE HALSEY ST",
            "address_2": "SUITE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131543",
            "telephone_number": "503-220-1332",
            "fax_number": "503-220-8531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 NE HALSEY ST",
            "address_2": "SUITE 101",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131543",
            "telephone_number": "503-220-1332",
            "fax_number": "503-220-8531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROSSEN",
        "first_name": "JOHN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Laurence Cross Jr., M.D.
• Roxanne Marie Cross, MS
• Shianne Cross, NCSP
• Crosscurrent, Inc.
• Holly Linn Crossen, PSY.D.
• Richard Frederick Crossley, QMHA
• Jesse Bard Crossno
• Tara Crosswhite, PA-C
• Charles Lawrence Croteau, D.O.
• Roger Croteau, RN

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.