Psych NW, PC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1929 Issued in OR

Legal business name

PSYCH NW, PC

Practice address

17704 Jean Way Ste 105
Lake Oswego, OR 97035-5586

Phone

(503) 877-0711

Fax

(503) 914-0315

NPI assigned

Mar 5, 2015

Last updated

Mar 5, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott T Alvord, PSY, DNPI 1013245455

Title

President

Phone

(503) 476-5005

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scott Thomas Alvord, PSYD

  • Psychologist
  • Aurora, OR
  • NPI 1013245455
  Medicare reassignment Care Compare group Authorized official
• Andrew Knowles, PSYD

  • Psychologist
  • Portland, OR
  • NPI 1497244354
  Medicare reassignment Care Compare group NPD
• Maya M Williams, PHD

  • Counseling Psychologist
  • Portland, OR
  • NPI 1215746383
  Medicare reassignment Care Compare group NPD
• Stephen Hans Stoltzfus, PSYD

  • Clinical Psychologist
  • Salem, OR
  • NPI 1942866470
  Medicare reassignment NPD
• Michelle Franke, PSYD

  • Clinical Psychologist
  • Salem, OR
  • NPI 1104732940
  NPD (past)
• Erin Vogel, MA

  • Counseling Psychologist
  • Salem, OR
  • NPI 1457818395
  NPD (past)

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

{
    "created_epoch": "1425513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1487047007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10024",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974402024",
            "telephone_number": "503-877-0711",
            "fax_number": "503-914-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17704 JEAN WAY STE 105",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970355586",
            "telephone_number": "503-877-0711",
            "fax_number": "503-914-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCH NW, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-05",
        "last_updated": "2015-03-05",
        "status": "A",
        "authorized_official_last_name": "ALVORD",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-476-5005",
        "authorized_official_credential": "PSY, D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Robin Prusse, RN,BSN
• Valeria Puk
• Judith Pullan, PH.D.
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• Pure Physical Therapy LLC

• Psychologist in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.