Individual provider Active NPI

R Scott Palmer, PH.D.

  • Psychologist
  • Lake Oswego, OR
National Provider Identifier
1851430276
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3063 Issued in OR
Practice address
3943 Tempest Dr
Lake Oswego, OR 97035-1928
Phone
(530) 518-2926
Fax
(530) 592-0506
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3603 OR
Psychologist 103T00000X 16155 CA
Clinical Psychologist 103TC0700X 16155 CA
Clinical Child & Adolescent Psychologist 103TC2200X 16155 CA
Family Psychologist 103TF0000X 16155 CA
Forensic Psychologist 103TF0200X 16155 CA
Psychologist 103T00000X 3063 OR Primary

Addresses

Primary practice location

3943 Tempest Dr
Lake Oswego, OR 97035-1928

Mailing address

155 B Ave Ste 220
Lake Oswego, OR 97034-3180
Phone (530) 518-2926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110628000754 CA Practitioner - Clinical Psychologist 1658558937 Practice locations: Chico, CA
I20200407002628 OR Practitioner - Clinical Psychologist 1658558937 Practice locations: Lake Oswego, OR

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Lake Oswego, OR 97035
Phone (530) 518-2926

22 Williamsburg LN
Suite a
Chico, CA 95926-2238
Phone (530) 518-2926

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
3063ORMDPsychologist
3603ORMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1851430276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 B AVE STE 220",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970343180",
            "telephone_number": "530-518-2926",
            "fax_number": "530-592-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3943 TEMPEST DR",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970351928",
            "telephone_number": "530-518-2926",
            "fax_number": "530-592-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "R",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3603",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "16155",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "16155",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "16155",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "CA",
            "license": "16155",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "CA",
            "license": "16155",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

Verify at the official NPI Registry.