Active NPI
Rachel Kirsten Greene, PHD
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1720699739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3514
- Practice address
- 707 SW Gaines St
Portland, OR 97239-2901 - Phone
- (800) 452-3563
- Fax
- (503) 494-4447
- NPI assigned
- Aug 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Psychologist | 103T00000X | 3514 | OR | |
| Clinical Psychologist | 103TC0700X | 3514 | OR | Primary |
Addresses
Primary practice location
707 SW Gaines St
Portland, OR 97239-2901
Mailing address
707 SW Gaines St
Portland, OR 97239-2901
Phone (800) 452-3563
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221021002526 | OR | Practitioner - Clinical Psychologist | 8022484682 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients | |
| University Professional Services | Current | Accepting new patients |
Locations
15700 SW Greystone Ct
Beaverton, OR 97006
Phone (503) 203-1000
707 SW Gaines St
Portland, OR 97239
Phone (503) 492-2709
Interoperability endpoints
- rgreene116760@direct.ohsu.edu
Organizations & group practices 3
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.
-
- Pharmacy
- Beaverton, OR
- NPI 1073054714
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Portland, OR
- NPI 1316354970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667260800000",
"number": "1720699739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 SW GAINES ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392901",
"telephone_number": "800-452-3563",
"fax_number": "503-494-4447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 SW GAINES ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392901",
"telephone_number": "800-452-3563",
"fax_number": "503-494-4447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENE",
"first_name": "RACHEL",
"middle_name": "KIRSTEN",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-13",
"last_updated": "2022-11-01",
"certification_date": "2022-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "3514",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "3514",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.