Active NPI
Odessa Cole, PHD
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1790153567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2553
- Practice address
- 3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964 - Phone
- (503) 220-8262
- NPI assigned
- Sep 9, 2015
- 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 Psychologist | 103TC0700X | 2553 | OR | Primary |
| Psychologist | 103T00000X | 2553 | OR |
Addresses
Primary practice location
3710 SW US Veterans Hospital Rd
Portland, OR 97239-2964
Mailing address
1790 NE Irving St Apt 10
Portland, OR 97232-2239
Phone (917) 572-2288
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2553 | OR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442016000000",
"number": "1790153567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1790 NE IRVING ST APT 10",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972322239",
"telephone_number": "917-572-2288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3710 SW US VETERANS HOSPITAL RD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972392964",
"telephone_number": "503-220-8262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "ODESSA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-09",
"last_updated": "2015-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "2553",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OR",
"license": "2553",
"primary": false
}
],
"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 Sep 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.