Nikki Frederick, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3016 Issued in OR

Practice address

1308 NW 20TH Ave Ste 7
Portland, OR 97209-1607

Phone

(801) 678-8375

NPI assigned

Sep 11, 2015

Sex

Female

Sole proprietor

Yes

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.

• Pacific University

  • Adult Mental Health Clinic/Center
  • Hillsboro, OR
  • NPI 1700256989
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 1, 2024.

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1902274632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 SW GOLF CREEK DR APT H",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972257304",
            "telephone_number": "801-678-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 NW 20TH AVE STE 7",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091607",
            "telephone_number": "801-678-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "NIKKI",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-11",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie E. Frederick, MD
• Eric J Frederick, AU.D
• Julie D. Frederick, PH.D.
• Kate R Frederick, RPH
• Meredith Claire Frederick, M.D.
• Erin Fredericks, MSCN
• Linda Joyce Thimsen Fredericks, FNP
• Melissa Fredette, PH.D.
• Alix Fredrickson, RPH
• Amanda Kristine Fredrickson, R.D.

• All providers in Portland, OR
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.