Individual provider Active NPI

Charles Nelson Zimmerman, PSY.D., M.A.

  • Psychologist
  • Portland, OR
National Provider Identifier
1669524740
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3261 Issued in OR
Practice address
2521 SE 41St Ave Unit 8
Portland, OR 97202-1888
Phone
(503) 319-5813
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3261 OR Primary

Addresses

Primary practice location

2521 SE 41St Ave Unit 8
Portland, OR 97202-1888

Mailing address

2521 SE 41St Ave Unit 8
Portland, OR 97202-1888
Phone (503) 319-5813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3261ORMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cascadia Adult Companion Past Accepting new patients
Cascadia Health Past Accepting new patients

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1669524740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 SE 41ST AVE UNIT 8",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021888",
            "telephone_number": "503-319-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 SE 41ST AVE UNIT 8",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021888",
            "telephone_number": "503-319-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMMERMAN",
        "first_name": "CHARLES",
        "middle_name": "NELSON",
        "name_prefix": "Dr.",
        "credential": "PSY.D., M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.