Shaun L Davis, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3017 Issued in OR

Practice address

470 N Villa Rd
Newberg, OR 97132-1858

Phone

(503) 495-3870

NPI assigned

Oct 10, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shaun Davis, PSYD, LLC

  • Clinical Psychologist
  • Newberg, OR
  • NPI 1770107187
  Medicare reassignment Authorized official
• Cornerstone Clinical Services PC

  • Community/Behavioral Health Agency
  • Milwaukie, OR
  • NPI 1093892895
  Medicare reassignment NPD
• Cornerstone Clinical Services, Inc

  • Community/Behavioral Health Agency
  • Lawton, OK
  • NPI 1184786238
  NPD

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1699240184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 327",
            "city": "YAMHILL",
            "state": "OR",
            "postal_code": "971480327",
            "telephone_number": "503-781-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 N VILLA RD",
            "city": "NEWBERG",
            "state": "OR",
            "postal_code": "971321858",
            "telephone_number": "503-495-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHAUN",
        "middle_name": "L",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Davigo, PH.D.
• Autumn Marie Irons Davis, MA
• Jamie Davis, MA, CCC-SLP
• Julianne Susan Davis, RN
• Natalie Davis, L.M.T
• Joeine Catherine De Kar
• Juliette Olivia Deacon
• Dean Pediatric Psychology, LLC
• Trinity Deibert, MS CCC-SLP
• Mason J Demaris

• Clinical Psychologist in Newberg, OR
• Providers in Newberg, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.