Active NPI
Judith C. Colwell, PH.D.
- Clinical Psychologist
- Beaverton, OR
National Provider Identifier
1710028253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 758
- Practice address
- 4900 SW Griffith Dr
Suite 261
Beaverton, OR 97005-5607 - Phone
- (503) 526-1949
- Fax
- (503) 627-9145
- NPI assigned
- Feb 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 758 | OR | Primary |
Addresses
Primary practice location
4900 SW Griffith Dr
Suite 261
Beaverton, OR 97005-5607
Mailing address
4900 SW Griffith Dr
Suite 261
Beaverton, OR 97005-5607
Phone (503) 526-1949
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 758 | OR | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David W Agnor PHD PC Dba Senior Connections | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Vancouver, WA
- NPI 1356652044
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710028253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4900 SW GRIFFITH DR",
"address_2": "SUITE 261",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970055607",
"telephone_number": "503-526-1949",
"fax_number": "503-627-9145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4900 SW GRIFFITH DR",
"address_2": "SUITE 261",
"city": "BEAVERTON",
"state": "OR",
"postal_code": "970055607",
"telephone_number": "503-526-1949",
"fax_number": "503-627-9145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLWELL",
"first_name": "JUDITH",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beaverton, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.