Individual provider Active NPI

Dianna Harris, PSYD, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bend, OR
National Provider Identifier
1598047045
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
202210894NP-PP Issued in OR
Practice address
1010 NW Harriman St Ste E
Bend, OR 97703-1912
Phone
(541) 516-6357
Fax
(877) 816-0645
NPI assigned
Sep 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2224 OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 202210894NP-PP OR Primary

Addresses

Primary practice location

1010 NW Harriman St Ste E
Bend, OR 97703-1912

Mailing address

1900 NE 3Rd St
Suite 106 PMB 3006
Bend, OR 97701-3889
Phone (541) 516-6357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111202000580 OR Practitioner - Clinical Psychologist 1557536505 Reassigns benefits to 1 organization
I20190131002793 OR Practitioner - Clinical Psychologist 1557536505 Practice locations: Beaverton, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10700 SW Beaverton Hillsdale Hwy
Suite 460
Beaverton, OR 97005-4736
Phone (541) 819-0519

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
202210894NP-PPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Sep 18, 2011 Accepting new patients
Western Psychological and Counseling Services LLC Clinical CurrentSince Sep 18, 2011 Accepting new patients

Locations

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1598047045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 NE 3RD ST",
            "address_2": "SUITE 106 PMB 3006",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013889",
            "telephone_number": "541-516-6357",
            "fax_number": "877-816-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 NW HARRIMAN ST STE E",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031912",
            "telephone_number": "541-516-6357",
            "fax_number": "877-816-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DIANNA",
        "name_prefix": "Dr.",
        "credential": "PSYD, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-11",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2224",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202210894NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.