Active NPI
Paul Sundstrom, ED.D.
- Psychologist
- Clackamas, OR
National Provider Identifier
1770623928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 607
- Practice address
- 8440 SE Sunnybrook Blvd
Ste 120
Clackamas, OR 97015-5780 - Phone
- (503) 653-0631
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 607 | OR | Primary |
Addresses
Primary practice location
8440 SE Sunnybrook Blvd
Ste 120
Clackamas, OR 97015-5780
Mailing address
8440 SE Sunnybrook Blvd
Ste 120
Clackamas, OR 97015-5780
Phone (503) 653-0631
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)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1770623928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8440 SE SUNNYBROOK BLVD",
"address_2": "STE 120",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970155780",
"telephone_number": "503-653-0631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8440 SE SUNNYBROOK BLVD",
"address_2": "STE 120",
"city": "CLACKAMAS",
"state": "OR",
"postal_code": "970155780",
"telephone_number": "503-653-0631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUNDSTROM",
"first_name": "PAUL",
"credential": "ED.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clackamas, OR
- Michelle Angelique Romero Sublett, MD
- Jeremy Suchanski
- Jeremy C Suess, DDS
- Alyssa Brianna Sullivan
- Brett Michael Sullivan, D.M.D., M.D.
- Sunny View Optometry LLC
- Sunnybrook - Addiction Medicine
- Sunnyside Dentistry for Children, P.C.
- Sunnyside Family Dentistry LLC
- Sunnyside Hood Residencial Treatment Home LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.