Portland Integrative Psychiatry

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

201405875 Issued in OR

Legal business name

PORTLAND INTEGRATIVE PSYCHIATRY

Practice address

14523 Westlake Dr
4
Lake Oswego, OR 97035-7700

Phone

(503) 765-5856

NPI assigned

Jan 12, 2017

Organization subpart

No

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

Authorized official

Name

Tracy Filley, PMHNP

Title

Owner

Phone

(503) 765-5856

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1689110868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14523 WESTLAKE DR",
            "address_2": "4",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14523 WESTLAKE DR",
            "address_2": "4",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970357700",
            "telephone_number": "503-765-5856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND INTEGRATIVE PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "FILLEY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-765-5856",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201405875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Joy Poncin
• Ponderosa Health, LLC
• Myranda Pool
• Svetlana V Poroshina
• Birch A Porter, MD
• Portland Optimal Wellness, LLC
• Portland Sports and Injury Center LLC
• Taylor Alysa Pottratz
• Diana Powell, BCBA
• Maura Powers

• Psychiatric/Mental Health Nurse Practitioner in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.