Active NPI
Landon Berger, PSY.D.
- Clinical Psychologist
- Hillsboro, OR
National Provider Identifier
1851731251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2255
- Practice address
- 6125 NE Cornell Rd Ste 290
Hillsboro, OR 97124-5417 - Phone
- (503) 389-5473
- NPI assigned
- Jun 28, 2013
- Last updated
- Mar 29, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2255 | OR | Primary |
Addresses
Primary practice location
6125 NE Cornell Rd Ste 290
Hillsboro, OR 97124-5417
Mailing address
2365 NW Irving St Apt 8
Portland, OR 97210-3392
Phone (503) 209-9218
Other practice location 1
2285 NW Johnson St Ste E
Portland, OR 97210-3236
Phone (503) 539-5546
Other practice location 2
2365 NW Irving St Apt 8
Portland, OR 97210-3392
Phone (503) 389-5473
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9049971 | Other | OR | DRIVERS LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2255 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1851731251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2365 NW IRVING ST APT 8",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972103392",
"telephone_number": "503-209-9218",
"fax_number": "503-372-5843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6125 NE CORNELL RD STE 290",
"city": "HILLSBORO",
"state": "OR",
"postal_code": "971245417",
"telephone_number": "503-389-5473"
}
],
"practiceLocations": [
{
"address_1": "2285 NW Johnson St Ste E",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972103236",
"country_code": "US",
"telephone_number": "503-539-5546",
"fax_number": "503-372-5843",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2365 NW Irving St Apt 8",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972103392",
"country_code": "US",
"telephone_number": "503-389-5473",
"fax_number": "503-372-5843",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERGER",
"first_name": "LANDON",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-28",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "2255",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "9049971",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hillsboro, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.