Active NPI
Rose Eagle, PH.D.
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1447586409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1951
- Practice address
- 7707 SW Capitol Hwy
Portland, OR 97219-2458 - Phone
- (503) 452-8002
- Fax
- (503) 452-0084
- NPI assigned
- Oct 27, 2009
- 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 | 1951 | OR | Primary |
Addresses
Primary practice location
7707 SW Capitol Hwy
Portland, OR 97219-2458
Mailing address
7707 SW Capitol Hwy
Portland, OR 97219-2458
Phone (503) 452-8002
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Program | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Developmental - Behavioral Pediatrics Physician
- Portland, OR
- NPI 1124187323
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256601600000",
"number": "1447586409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7707 SW CAPITOL HWY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972192458",
"telephone_number": "503-452-8002",
"fax_number": "503-452-0084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7707 SW CAPITOL HWY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972192458",
"telephone_number": "503-452-8002",
"fax_number": "503-452-0084"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGLE",
"first_name": "ROSE",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-27",
"last_updated": "2009-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1951",
"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 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.