Susanne Duvall, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2463 Issued in OR

Practice address

707 SW Gaines St
Portland, OR 97239-2901

Phone

(503) 494-1557

NPI assigned

Sep 2, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Susanne Woolsey Former name

Medicare fee-for-service enrollment

Enrolled in OR

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sduvall78173@direct.ohsu.edu

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.

• University Professional Services

  • General Practice Physician
  • Portland, OR
  • NPI 1376709535
  Medicare reassignment NPD
• University Professional Services

  • Pharmacy
  • Beaverton, OR
  • NPI 1073054714
  NPD

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1629478235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SW GAINES ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SW GAINES ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972392901",
            "telephone_number": "503-494-1557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVALL",
        "first_name": "SUSANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNE",
            "last_name": "WOOLSEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maria Leticia Duval, DMD
• Stephanie Duval
• Trenton Duval
• Natalia V. Duvalko, DDS
• Sachie Kiyoko Duvall, PWS
• Hilary Gabrielle Duvauchelle, PMHNP-BC, FNP-BC
• Kelly Marie Duvendack, L.AC.
• Paul J Duwelius, MD
• Renee K Dversdal, M.D.
• Tammy Dvir

• 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 Sep 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.