Kellie Oosterbaan PSYD Rd PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1642 Issued in OR

Legal business name

KELLIE OOSTERBAAN PSYD RD PC

Practice address

1100 E Marina Way Ste 221
Hood River, OR 97031-2353

Phone

(541) 386-6070

Fax

(541) 610-1955

NPI assigned

Nov 18, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kellie Oosterbaan, PSYD RD

Title

President

Phone

(541) 788-5744

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kellie Oosterbaan Wolff

  • Clinical Psychologist
  • Hood River, OR
  • NPI 1982778312
  Medicare reassignment NPD
• Brian Wolff, LCSW, CADC-III

  • Clinical Social Worker
  • Hood River, OR
  • NPI 1508096397
  NPD
• Michael Vargo Stevens, LCSW

  • Clinical Social Worker
  • Hood River, OR
  • NPI 1679605695
  NPD (past)

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

{
    "created_epoch": "1163808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358294400000",
    "number": "1609940030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 COLUMBIA ST",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970311720",
            "telephone_number": "541-788-5744",
            "fax_number": "541-610-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E MARINA WAY STE 221",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970312353",
            "telephone_number": "541-386-6070",
            "fax_number": "541-610-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLIE OOSTERBAAN PSYD RD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-18",
        "last_updated": "2013-01-16",
        "status": "A",
        "authorized_official_last_name": "OOSTERBAAN",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-788-5744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD  RD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KDKN Inc
• KDKN Inc
• KDKN Inc
• Ryan M. Kealy, M.D.
• Conner Grace Keeffe
• Melanie Muirden Kelly, LCSW
• Jennifer Rose Kelson
• Jack H Kennady, DO
• Jaleh Kermani
• Raelynn Keron, LMT

• Clinical Psychologist in Hood River, OR
• Providers in Hood River, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.