Active NPI
Courtney Spink, PSYD
- Psychologist
- Portland, OR
National Provider Identifier
1750816138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3897
- Practice address
- 2801 N Gantenbein Ave
Portland, OR 97227-1623 - Phone
- (503) 276-6500
- NPI assigned
- Apr 24, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 3897 | OR | |
| Psychologist | 103T00000X | 3897 | OR | Primary |
Addresses
Primary practice location
2801 N Gantenbein Ave
Portland, OR 97227-1623
Mailing address
2801 N Gantenbein Ave
Portland, OR 97227-1623
Phone (503) 276-6500
Other practice location 1
2800 N Vancouver Ave Ste 165
Portland, OR 97227-1644
Phone (503) 413-2902
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3897 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mangata Wellness, Inc | Past | Accepting new patients | |
| Pacific University | Past | Accepting new patients |
Organizations & group practices 2
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
- Salem, OR
- NPI 1790419158
-
- Adult Mental Health Clinic/Center
- Hillsboro, OR
- NPI 1700256989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723766400000",
"number": "1750816138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 N GANTENBEIN AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271623",
"telephone_number": "503-276-6500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2801 N GANTENBEIN AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972271623",
"telephone_number": "503-276-6500"
}
],
"practiceLocations": [
{
"address_1": "2800 N Vancouver Ave Ste 165",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972271644",
"country_code": "US",
"telephone_number": "503-413-2902",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SPINK",
"first_name": "COURTNEY",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-24",
"last_updated": "2024-08-16",
"certification_date": "2024-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "OR",
"license": "3897",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "3897",
"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 Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.