Individual provider Active NPI

Arthur Eugene Kowitch, PH.D.

  • Psychologist
  • Portland, OR
National Provider Identifier
1386786986
Registry record updated Oct 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1190 Issued in OR
Practice address
825 NE 20TH Ave
206
Portland, OR 97232-2275
Phone
(504) 234-7104
Fax
(503) 233-7872
NPI assigned
Feb 12, 2007
Last updated
Oct 31, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1190 OR Primary

Addresses

Primary practice location

825 NE 20TH Ave
206
Portland, OR 97232-2275

Mailing address

825 NE 20TH Ave
206
Portland, OR 97232-2275
Phone (504) 234-7104

Other identifiers 1

IdentifierTypeStateIssuer
079389MedicaidOR

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
I20071116000072 OR Practitioner - Clinical Psychologist 1456449917 Practice locations: Portland, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

825 NE 20TH Ave
Portland, OR 97232-2275
Phone (503) 234-7104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1190ORMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1386786986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 NE 20TH AVE",
            "address_2": "206",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322275",
            "telephone_number": "504-234-7104",
            "fax_number": "503-233-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NE 20TH AVE",
            "address_2": "206",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322275",
            "telephone_number": "504-234-7104",
            "fax_number": "503-233-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOWITCH",
        "first_name": "ARTHUR",
        "middle_name": "EUGENE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079389",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.