Jill S Waldman, PSY.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

2703 Issued in OR

Practice address

1130 SW Morrison St
619 & 630
Portland, OR 97205-2234

Phone

(971) 256-2314

Fax

(503) 841-5389

NPI assigned

Aug 13, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1932355674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 SW MORRISON ST",
            "address_2": "SUITE 619 & 630",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052234",
            "telephone_number": "971-256-2314",
            "fax_number": "503-841-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 SW MORRISON ST",
            "address_2": "619 & 630",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972052234",
            "telephone_number": "971-256-2314",
            "fax_number": "503-841-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDMAN",
        "first_name": "JILL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-13",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OR",
            "license": "2703",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "OR",
            "license": "2703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Walddon
• James Barry Walden, PWS
• Melody Walden
• Jessie Walder-Biesanz
• James Roger Waldman, MD
• George Waldmann, M. D.
• Joanna Waldner
• Jennifer Waldo
• Jessica Amber Waldo
• Jennifer Pearl Waldorf, LPC

• Cognitive & Behavioral Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Cognitive & Behavioral Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.

Verify at the official NPI Registry.