Jessica J Paxton, PSYD
Individual provider Active NPI Clinical Psychologist · Tigard, OR
NPI 1720596398 · NPPES record last updated Nov 2, 2022
Key facts
- NPI
- 1720596398
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 3601 (OR)
- Practice address
- 12442 SW Scholls Ferry Rd Ste 100
Tigard, OR 97223-0803 - Phone
- (503) 216-9200
- NPI assigned
- Jan 17, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Mid Valley Counseling Center Inc
Practice addresses (Care Compare)
470 N Villa Rd
Newberg, OR 97132-1858
Phone (503) 538-8970
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221108002712 | OR | Practitioner - Clinical Psychologist | 9830566645 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3601 | OR | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid Valley Counseling Center Inc | Clinical | Current |
Accepting new patients |
| George Fox University | Past | Accepting new patients |
Locations
470 N Villa Rd
Newberg, OR 97132
Phone (503) 495-3870
2250 D St NE
Salem, OR 97301
Phone (503) 364-6093
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Psychologist | 103TC0700X | 3601 | OR | Yes |
Addresses
Primary practice location
12442 SW Scholls Ferry Rd Ste 100
Tigard, OR 97223-0803
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494
Other practice location 1
414 N Meridian St
Newberg, OR 97132-2697
Phone (503) 554-2390
Other providers in Tigard, OR
- Angela Patterson
- Dustin Pattison
- Paul Lau, OD and Maggie Man Ki Ho, OD, Ms, Faao, LLC
- Celina Paul
- Guner Ray Pavey
- Elizabeth Payne
- Meagan Mae Payne
- Natalyia Payne
- Erin Teresa Peace
- Peacehealth Networks on Demand, LLC
All providers in Tigard, OR · Clinical Psychologist in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.