Active NPI
Kimberly R Goodale, PSY.D.
- Clinical Psychologist
- Beaverton, OR
National Provider Identifier
1427260249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1743
- Practice address
- 1975 NW 167TH PL Ste 100-4
Beaverton, OR 97006-4908 - Phone
- (503) 500-5610
- Fax
- (503) 500-5650
- NPI assigned
- May 4, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Psychologist | 103TH0004X | 1743 | OR | |
| Clinical Psychologist | 103TC0700X | 1743 | OR | Primary |
Addresses
Primary practice location
1975 NW 167TH PL Ste 100-4
Beaverton, OR 97006-4908
Mailing address
1975 NW 167TH PL Ste 100-4
Beaverton, OR 97006-4908
Phone (503) 500-5610
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645747200000",
"number": "1427260249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1975 NW 167TH PL STE 100-4",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970064908",
"telephone_number": "503-500-5610",
"fax_number": "503-500-5650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1975 NW 167TH PL STE 100-4",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970064908",
"telephone_number": "503-500-5610",
"fax_number": "503-500-5650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODALE",
"first_name": "KIMBERLY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2022-02-25",
"certification_date": "2022-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "OR",
"license": "1743",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.