Active NPI
Karlaina Matthews Brooke, PSY.D.
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1760600480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1623
- Practice address
- 975 SE Sandy Blvd Ste 160
Portland, OR 97214-2498 - Phone
- (503) 893-4419
- NPI assigned
- Apr 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 Psychologist | 103TC0700X | PY00003079 | WA | |
| Clinical Psychologist | 103TC0700X | 1623 | OR | Primary |
Addresses
Primary practice location
975 SE Sandy Blvd Ste 160
Portland, OR 97214-2498
Mailing address
975 SE Sandy Blvd Ste 160
Portland, OR 97214-2498
Phone (503) 893-4419
Other practice location 1
400 E Evergreen Blvd Ste 208
Vancouver, WA 98660-3264
Phone (503) 893-4419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2025 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1623 | OR | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brooke Psychologists, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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
- Portland, OR
- NPI 1093980070
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1760600480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975 SE SANDY BLVD STE 160",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142498",
"telephone_number": "503-893-4419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 SE SANDY BLVD STE 160",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972142498",
"telephone_number": "503-893-4419"
}
],
"practiceLocations": [
{
"address_1": "400 E Evergreen Blvd Ste 208",
"address_purpose": "LOCATION",
"city": "Vancouver",
"state": "WA",
"postal_code": "986603264",
"country_code": "US",
"telephone_number": "503-893-4419",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BROOKE",
"first_name": "KARLAINA",
"middle_name": "MATTHEWS",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY00003079",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1623",
"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 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.