Chantal Alyse Van Wely, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME158562 Issued in FL

Practice address

11825 SW Greenburg Rd Ste 206
Tigard, OR 97223-6466

Phone

(503) 395-4626

Fax

(503) 386-3294

NPI assigned

May 21, 2021

Sex

Female

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

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Professional Mental Health Care LLC

  • Psychiatry Physician
  • Tigard, OR
  • NPI 1437866027
  NPD

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1851966048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 14TH ST SW",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11825 SW GREENBURG RD STE 206",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972236466",
            "telephone_number": "503-395-4626",
            "fax_number": "503-386-3294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WELY",
        "first_name": "CHANTAL",
        "middle_name": "ALYSE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD223876",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME158562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Van Houten, PA-C
• Linnea Gray Van Kirk, LMFT
• William Van Sant
• Carolina Alexandra Van Tulder, PA-C
• Lecia Marion Van Valkenburg
• Alexandra Domonique Van
• Davy Elizabeth Vandersommen, LMT
• Larissa Vanderwall
• Vanguard Or LLC
• Vanguard Or LLC

• Psychiatry Physician in Tigard, OR
• Providers in Tigard, OR by specialty
• Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.