Active NPI
Traci Rieckmann, PH.D.
- Counseling Psychologist
- Portland, OR
National Provider Identifier
1861850737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- Practice address
- 2925 NE 53Rd Ave
Portland, OR 97213-2437 - Phone
- (503) 577-3414
- NPI assigned
- Feb 5, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | Primary |
Addresses
Primary practice location
2925 NE 53Rd Ave
Portland, OR 97213-2437
Mailing address
3601 SW River Pkwy
Suite 2012
Portland, OR 97239-4553
Phone (503) 577-3414
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454630400000",
"number": "1861850737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3601 SW RIVER PKWY",
"address_2": "SUITE 2012",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394553",
"telephone_number": "503-577-3414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2925 NE 53RD AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972132437",
"telephone_number": "503-577-3414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIECKMANN",
"first_name": "TRACI",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-05",
"last_updated": "2016-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": null,
"license": null,
"primary": true
}
],
"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 Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.