Individual provider Active NPI

William A. Blakey, PH.D.

  • Psychologist
  • Gladstone, OR
National Provider Identifier
1497859888
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1146 Issued in OR
Practice address
880 82ND Dr
Gladstone, OR 97027-1803
Phone
(503) 659-5515
Fax
(503) 659-1994
NPI assigned
Sep 7, 2006
Last updated
Nov 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1146 OR Primary
Clinical Psychologist 103TC0700X 1146 OR

Addresses

Primary practice location

880 82ND Dr
Gladstone, OR 97027-1803

Mailing address

10931 SE Cedar Way
Happy Valley, OR 97086
Phone (503) 698-4212

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050511001018 OR Practitioner - Clinical Psychologist 3375583016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1750 Blankenship Rd
Suite 400
West Linn, OR 97068-5102
Phone (503) 659-5515

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1146ORMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Apr 1, 2005 Accepting new patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Apr 1, 2005 Accepting new patients

Locations

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

10151 SE Sunnyside Rd
Ste 480
Happy Valley, OR 97015
Phone (503) 739-8321

1750 Blankenship Rd
Ste 400
West Linn, OR 97068
Phone (503) 659-5515

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.williamblakey@148835.advancedmd-direct.com

Organizations & group practices 2

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1497859888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10931 SE CEDAR WAY",
            "city": "HAPPY VALLEY",
            "state": "OR",
            "postal_code": "97086",
            "telephone_number": "503-698-4212",
            "fax_number": "503-659-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 82ND DR",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970271803",
            "telephone_number": "503-659-5515",
            "fax_number": "503-659-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKEY",
        "first_name": "WILLIAM",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "1146",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladstone, OR

Sources for this page

Verify at the official NPI Registry.