Individual provider Active NPI

Tamara Lynn Hoogestraat, PSY.D., M.B.A.

  • Clinical Psychologist
  • West Linn, OR
National Provider Identifier
1871787754
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1967 Issued in OR
Practice address
21900 Willamette Dr Ste 120
West Linn, OR 97068-3280
Phone
(503) 653-0631
Fax
(503) 653-1464
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1967 OR Primary

Addresses

Primary practice location

21900 Willamette Dr Ste 120
West Linn, OR 97068-3280

Mailing address

21900 Willamette Dr Ste 120
West Linn, OR 97068-3280
Phone (503) 653-0631

Other practice location 1

8440 SE Sunnybrook Blvd
Suite 120
Clackamas, OR 97015-5780
Phone (503) 653-0631

Other identifiers 1

IdentifierTypeStateIssuer
1967OtherORLICENSE

Other names 1

  • Tami Hoogestraat Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100220000425 OR Practitioner - Clinical Psychologist 4587708110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21900 Willamette Dr
Suite 202
West Linn, OR 97068-3284
Phone (503) 653-0631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

State licenses

LicenseStateTypeSpecialty
1967ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Sundstrom Clinical Services LLC CurrentSince Jan 20, 2010 Accepting new patients

Locations

8440 SE Sunnybrook Blvd
Ste 120
Clackamas, OR 97015
Phone (503) 653-0631

21900 Willamette Dr
Ste 202
West Linn, OR 97068
Phone (503) 653-0631

Interoperability endpoints

  • Direct secure messaging: tamara.hoogestraat.1@32989.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1871787754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21900 WILLAMETTE DR STE 120",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683280",
            "telephone_number": "503-653-0631",
            "fax_number": "503-653-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21900 WILLAMETTE DR STE 120",
            "city": "WEST LINN",
            "state": "OR",
            "postal_code": "970683280",
            "telephone_number": "503-653-0631",
            "fax_number": "503-653-1464"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8440 SE Sunnybrook Blvd",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970155780",
            "country_code": "US",
            "telephone_number": "503-653-0631",
            "fax_number": "503-653-1464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOOGESTRAAT",
        "first_name": "TAMARA",
        "middle_name": "LYNN",
        "credential": "PSY.D., M.B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1967",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMI",
            "last_name": "HOOGESTRAAT",
            "credential": "M.A., M.B.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in West Linn, OR

Sources for this page

Verify at the official NPI Registry.