Breakwater Psychology, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

BREAKWATER PSYCHOLOGY, LLC

Practice address

1206 SE 163Rd PL
Portland, OR 97233-4062

Phone

(415) 264-1686

NPI assigned

Feb 25, 2026

Organization subpart

No

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

Authorized official

Name

Mrs. Michelle Pollard

Title

Owner

Phone

(415) 264-1686

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1771977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786060800000",
    "number": "1467306407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 SE 163RD PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972334062",
            "telephone_number": "415-264-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 SE 163RD PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972334062",
            "telephone_number": "415-264-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAKWATER PSYCHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-25",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A",
        "authorized_official_last_name": "POLLARD",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-264-1686",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.