Active NPI
David C Wade, PSY D
- Clinical Psychologist
- Hood River, OR
National Provider Identifier
1891838835
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1081
- Practice address
- 1100 E Marina Way
Suite 221
Hood River, OR 97031-2305 - Phone
- (541) 436-2998
- Fax
- (541) 436-2998
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 1081 | OR | Primary |
Addresses
Primary practice location
1100 E Marina Way
Suite 221
Hood River, OR 97031-2305
Mailing address
1100 E Marina Way
Ste 221
Hood River, OR 97031-2353
Phone (509) 493-1467
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 400707 | Other | OR | VALUE OPTIONS |
| 885235000 | Other | OR | REGENCE BCBSO |
| YC73001 | Other | OR | PACIFIC SOURCE |
| 115025 | Other | OR | MANAGED HEALTH NETWORK |
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 |
|---|---|---|---|
| 1081 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526947200000",
"number": "1891838835",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 E MARINA WAY",
"address_2": "STE 221",
"city": "HOOD RIVER",
"state": "OR",
"postal_code": "970312353",
"telephone_number": "509-493-1467",
"fax_number": "509-493-3765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 E MARINA WAY",
"address_2": "SUITE 221",
"city": "HOOD RIVER",
"state": "OR",
"postal_code": "970312305",
"telephone_number": "541-436-2998",
"fax_number": "541-436-2998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "DAVID",
"middle_name": "C",
"credential": "PSY D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2018-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1081",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "400707",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BCBSO",
"identifier": "885235000",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PACIFIC SOURCE",
"identifier": "YC73001",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "115025",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hood River, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.