Larry Edwin Raymond Jasper, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3164 Issued in OR

Practice address

22566 SW Washington St Ste 202
Sherwood, OR 97140-7923

Phone

(503) 752-0213

NPI assigned

Jan 26, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1710577424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22566 SW WASHINGTON ST STE 202",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971407923",
            "telephone_number": "503-752-0213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22566 SW WASHINGTON ST STE 202",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971407923",
            "telephone_number": "503-752-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JASPER",
        "first_name": "LARRY",
        "middle_name": "EDWIN RAYMOND",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Sherwood",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "22566 SW Washington St Ste 202",
            "city": "Sherwood",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971407923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychologist in Sherwood, OR
• Providers in Sherwood, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.