Individual provider Active NPI

Vanessa Marie Welch-Pemberton, PSY. D.

  • Clinical Psychologist
  • Camas, WA
National Provider Identifier
1700194149
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2918 Issued in OR
Practice address
3708 NE 292ND Ave
Camas, WA 98607-8126
Phone
(360) 524-2201
Fax
(564) 227-3055
NPI assigned
Sep 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY60248926 WA
Clinical Psychologist 103TC0700X 2918 OR Primary

Addresses

Primary practice location

3708 NE 292ND Ave
Camas, WA 98607-8126

Mailing address

800 SW 13TH Ave
Portland, OR 97205
Phone (503) 221-0161

Other names 1

  • Vanessa Marie Welch Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130829000511 WA Practitioner - Clinical Psychologist 6507009180 Reassigns benefits to 1 organization
I20181214001431 OR Practitioner - Clinical Psychologist 6507009180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Keizer, OR 97303
Phone (509) 251-9513

Camas, WA 98607
Phone (509) 251-9513

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY60248926WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Portland Clinic CurrentSince Jan 1, 2023 Accepting new patients
Empower Through PLLC CurrentSince Jun 15, 2025 Accepting new patients
Front Street Clinic Inc Past Accepting new patients
Wandee J. Pryor, Psy.D., LLC Past Accepting new patients

Locations

800 SW 13th Ave
Portland, OR 97205
Phone (503) 221-0161

5005 NE Sandy Blvd
Portland, OR 97213
Phone (503) 233-6940

9250 SW Hall Blvd
Tigard, OR 97223
Phone (503) 221-0161

Organizations & group practices 4

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": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1700194149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SW 13TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-221-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 NE 292ND AVE",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986078126",
            "telephone_number": "360-524-2201",
            "fax_number": "564-227-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELCH-PEMBERTON",
        "first_name": "VANESSA",
        "middle_name": "MARIE",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-20",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60248926",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "WELCH",
            "middle_name": "MARIE",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Camas, WA

Sources for this page

Verify at the official NPI Registry.