Active NPI
Angeline L Whitelaw, PSY.D.
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1538406772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2359
- Practice address
- 610 SW Broadway Ste 306
Portland, OR 97205-3404 - Phone
- (503) 828-1065
- NPI assigned
- Jan 8, 2013
- Last updated
- Feb 28, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 2359 | OR | Primary |
Addresses
Primary practice location
610 SW Broadway Ste 306
Portland, OR 97205-3404
Mailing address
610 SW Broadway Ste 306
Portland, OR 97205-3404
Phone (503) 828-1065
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2359 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551312000000",
"number": "1538406772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 SW BROADWAY STE 306",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972053404",
"telephone_number": "503-828-1065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 SW BROADWAY STE 306",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972053404",
"telephone_number": "503-828-1065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITELAW",
"first_name": "ANGELINE L",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-08",
"last_updated": "2019-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "2359",
"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 Feb 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.