Anneke P Hathaway, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

636 Issued in OR

Practice address

5050 NE Hoyt St
Suite 422
Portland, OR 97213-2991

Phone

(360) 263-5406

Fax

(360) 263-5406

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1578674115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87670",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986877670",
            "telephone_number": "360-263-5420",
            "fax_number": "360-263-5406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 NE HOYT ST",
            "address_2": "SUITE 422",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972132991",
            "telephone_number": "360-263-5406",
            "fax_number": "360-263-5406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATHAWAY",
        "first_name": "ANNEKE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "208446",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111955",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Hatfield, DO
• Joanna Laurel Hatfield, M.D.
• Katherine Noelle Hatfield
• Mark Travis Hatfield, DPT
• Rachel Hathaway-Boschee, BCABA
• Chalese Marie Hathaway, DC
• Charles Richard Hathaway, D.C
• Jill L. Hathaway, LAC
• Mark Allen Hathaway
• Nicole Christine Hathaway, MA, CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.