Luke E. Patrick, PH.D.

Primary specialty

Exercise & Sports PsychologistTaxonomy code 103TE1100X

License

1491 Issued in OR

Practice address

12250 SW Garden PL
Portland, OR 97223-8246

Phone

(503) 684-7246

Fax

(503) 624-0724

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2017 through Jan 1, 2027

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 and National Provider Directory roles.

• Northwest Occupational Medicine Center Inc.

  • Multi-Specialty Clinic/Center
  • Beaverton, OR
  • NPI 1407882772
  NPD (past)
• NW Occupational Medicine Center

  • Multi-Specialty Clinic/Center
  • Portland, OR
  • NPI 1790921534
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1821025495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5739 SW TEXAS ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191257",
            "telephone_number": "503-452-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12250 SW GARDEN PL",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238246",
            "telephone_number": "503-684-7246",
            "fax_number": "503-624-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "LUKE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "OR",
            "license": "1491",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "OR",
            "license": "1491",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Patrick, CSWA
• Christine Patrick
• Daniel Jaylin Patrick
• Emma Patrick
• Kirstin Marie Patrick
• Shawn Timothy Patrick, M.D.
• Roberto L Patron, MD
• Sarah Lincoln Pattee
• Angela Delrae Patten, LMT
• Rachel Patten, MSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.