Shelly Bernard Getzlaf, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

717 Issued in OR

Practice address

1017 SW Morrison St
Ste 411
Portland, OR 97205-2629

Phone

(503) 646-4664

Fax

(503) 521-7041

NPI assigned

Dec 15, 2006

Last updated

Feb 28, 2018By the provider in NPPES

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

Other identifiers 1

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Bipolar Treatment Program

  dba Shelly B Getzlaf, PhD

  • Adult Mental Health Clinic/Center
  • Portland, OR
  • NPI 1891150983
  NPD (past) Authorized official
• Judith Lynn Pulliam

  • Adult Mental Health Clinic/Center
  • Beaverton, OR
  • NPI 1588211510
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1760544571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 SW MORRISON ST",
            "address_2": "STE 411",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052629",
            "telephone_number": "503-646-4664",
            "fax_number": "503-521-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 SW MORRISON ST",
            "address_2": "STE 411",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052629",
            "telephone_number": "503-646-4664",
            "fax_number": "503-521-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GETZLAF",
        "first_name": "SHELLY",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000476",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marie Getman, B.S.
• Victoria Gettel
• Ava Elizabeth Gettinger, ND
• Karen Anne Gettmann, LMT
• Anthony Jerome Getz
• Lindsey Ann Geunes, CNM, WHNP
• Cory Geurts, CPHT
• Steve Gevurtz
• Jacob Geyen
• GFM LLC (Great Forest Medicine Acupuncture and Herbs)

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.

Verify at the official NPI Registry.