Central Oregon Cognitive Assessment & Rehabilitation

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CENTRAL OREGON COGNITIVE ASSESSMENT & REHABILITATION

Practice address

19855 4TH St Ste 106
Bend, OR 97703-7814

Phone

(541) 316-0648

Fax

(541) 610-1550

NPI assigned

May 23, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Theresa Lee Demadura, PHDNPI 1023501665

Title

Owner

Phone

(503) 314-6942

Specialties & licenses 1

Addresses

Other names 1

• COCAR Other name

Practitioners 1

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

• Theresa Demadura, CLINCAL PSYCHOLOGIST

  • Clinical Psychologist
  • Portland, OR
  • NPI 1023501665

  Clinical

  NPD Authorized official

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1619669017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8778 COOPERS HAWK DR",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977565012",
            "telephone_number": "503-314-6942",
            "fax_number": "541-610-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19855 4TH ST STE 106",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977037814",
            "telephone_number": "541-316-0648",
            "fax_number": "541-610-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL OREGON COGNITIVE ASSESSMENT & REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-23",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "DEMADURA",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-314-6942",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COCAR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Bend, OR
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.