Individual provider Active NPI

Thomas Pankau, PHD

  • Clinical Psychologist
  • Portland, OR
National Provider Identifier
1467128876
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3991 Issued in OR
Practice address
2525 NW Lovejoy St
Portland, OR 97210-2859
Phone
(206) 617-5982
NPI assigned
Aug 17, 2021
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3991 OR Primary
Clinical Psychologist 103TC0700X 35135 CA
Specialist 174400000X NU

Addresses

Primary practice location

2525 NW Lovejoy St
Portland, OR 97210-2859

Mailing address

1985 NW Savier St # N206
Portland, OR 97209-4303
Phone (206) 617-5982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250217001292 CA Practitioner - Clinical Psychologist 0749710028 Reassigns benefits to 1 organization
I20251003003777 OR Practitioner - Clinical Psychologist 0749710028 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2525 NW Lovejoy St
Suite 204
Portland, OR 97210-2863
Phone (503) 563-3420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3991ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc Current Accepting new patients
Permanente Medical Group, Inc CurrentSince Dec 11, 2024 Accepting new patients
Permanente Medical Group Inc CurrentSince Dec 11, 2024 Accepting new patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Sep 22, 2025 Accepting new patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Sep 22, 2025 Accepting new patients
Solutions Behavioral Healthcare Professionals, PC Clinical PastSince Aug 1, 2021 Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

5820 Owens Dr
Bldg E
Pleasanton, CA 94588
Phone (925) 737-3785

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

501 J St
Sacramento, CA 95814
Phone (916) 497-3000

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

111 Smith Ranch Rd
San Rafael, CA 94903
Phone (415) 491-3000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

2525 NW Lovejoy St
Ste 204
Portland, OR 97210
Phone (503) 563-3420

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1467128876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1985 NW SAVIER ST # N206",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972094303",
            "telephone_number": "206-617-5982",
            "fax_number": "206-617-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 NW LOVEJOY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102859",
            "telephone_number": "206-617-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANKAU",
        "first_name": "THOMAS",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-17",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3991",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "35135",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.