Individual provider Active NPI

Stephen R Condon, PH.D.

  • Psychologist
  • Pendleton, OR
National Provider Identifier
1689604290
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
570 Issued in OR
Practice address
27 SW Frazer Ave
Pendleton, OR 97801-2147
Phone
(541) 278-2222
Fax
(541) 276-8405
NPI assigned
Jul 3, 2006
Last updated
Feb 18, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 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 570 OR Primary

Addresses

Primary practice location

27 SW Frazer Ave
Pendleton, OR 97801-2147

Mailing address

27 SW Frazer Ave
Pendleton, OR 97801-2147
Phone (541) 278-2222

Other identifiers 2

IdentifierTypeStateIssuer
808119000OtherORREGENCE BLUE CROSS BLUE S
010673MedicaidOR

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070501000027 OR Practitioner - Clinical Psychologist 1951375864 Practice locations: Pendleton, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

125 SE Court Ave
Suite 4
Pendleton, OR 97801-2251
Phone (541) 278-4123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1689604290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 SW FRAZER AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978012147",
            "telephone_number": "541-278-2222",
            "fax_number": "541-276-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 SW FRAZER AVE",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978012147",
            "telephone_number": "541-278-2222",
            "fax_number": "541-276-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDON",
        "first_name": "STEPHEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE CROSS BLUE S",
            "identifier": "808119000",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010673",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pendleton, OR

Sources for this page

Verify at the official NPI Registry.