Active NPI
Peter H. Crabtree, PSY.D.
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1407073729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1112
- Practice address
- 2188 SW Park Place
Ste. 202
Portland, OR 97205 - Phone
- (503) 274-9339
- NPI assigned
- Apr 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 1112 | OR | Primary |
Addresses
Primary practice location
2188 SW Park Place
Ste. 202
Portland, OR 97205
Mailing address
2188 SW Park Place
Ste. 202
Portland, OR 97205
Phone (503) 274-9339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1112 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347408000000",
"number": "1407073729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2188 SW PARK PLACE",
"address_2": "STE. 202",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97205",
"telephone_number": "503-274-9339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2188 SW PARK PLACE",
"address_2": "STE. 202",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97205",
"telephone_number": "503-274-9339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRABTREE",
"first_name": "PETER",
"middle_name": "H.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2012-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1112",
"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 Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.