Active NPI
Miriam Joy Anderson, PH.D.
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1407002850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2286
- Practice address
- 516 SE Morrison St Ste 1110
Portland, OR 97214-2390 - Phone
- (503) 222-0707
- NPI assigned
- Aug 15, 2008
- Last updated
- Oct 15, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2286 | OR | Primary |
Addresses
Primary practice location
516 SE Morrison St Ste 1110
Portland, OR 97214-2390
Mailing address
516 SE Morrison St Ste 1110
Portland, OR 97214-2390
Phone (503) 222-0707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 27, 2021 through Sep 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381795200000",
"number": "1407002850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "516 SE MORRISON ST STE 1110",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142390",
"telephone_number": "503-222-0707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "516 SE MORRISON ST STE 1110",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142390",
"telephone_number": "503-222-0707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MIRIAM",
"middle_name": "JOY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-15",
"last_updated": "2013-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "2286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.