Active NPI
Douglas B Golden, PH.D.
- Clinical Psychologist
- Portland, OR
National Provider Identifier
1902013345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 391
- Practice address
- 3434 SW Kelly Ave
Portland, OR 97239-4630 - Phone
- (503) 228-6071
- NPI assigned
- May 16, 2007
- 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 | 391 | OR | Primary |
Addresses
Primary practice location
3434 SW Kelly Ave
Portland, OR 97239-4630
Mailing address
3434 SW Kelly Ave
Portland, OR 97239-4630
Phone (503) 228-6071
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2018 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1902013345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3434 SW KELLY AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394630",
"telephone_number": "503-228-6071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3434 SW KELLY AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972394630",
"telephone_number": "503-228-6071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDEN",
"first_name": "DOUGLAS",
"middle_name": "B",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "391",
"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 Jul 8, 2007; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.