Organization Active NPI

Alpenglow Psychiatry P.C.

  • Child & Adolescent Psychiatry Physician
  • Portland, OR
National Provider Identifier
1417740077
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
ALPENGLOW PSYCHIATRY P.C.
Practice address
5441 S Macadam Ave # 4717
Portland, OR 97239-6106
Phone
(503) 926-9460
Fax
(971) 350-1563
NPI assigned
May 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

Name
Dr. Devraux R Boshard, DO
Title
President
Phone
(503) 926-9460

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

5441 S Macadam Ave # 4717
Portland, OR 97239-6106

Mailing address

5441 S Macadam Ave # 4717
Portland, OR 97239-6106
Phone (503) 926-9460

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1417740077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE # 4717",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396106",
            "telephone_number": "503-926-9460",
            "fax_number": "971-350-1563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5441 S MACADAM AVE # 4717",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972396106",
            "telephone_number": "503-926-9460",
            "fax_number": "971-350-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALPENGLOW PSYCHIATRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "BOSHARD",
        "authorized_official_first_name": "DEVRAUX",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-926-9460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "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 May 27, 2025; 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.