Individual provider Active NPI

Sonia C Izmirian, PH.D.

  • Clinical Psychologist
  • Portland, OR
National Provider Identifier
1932481538
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3858 Issued in OR
Practice address
1750 SW Skyline Blvd Ste 201
Portland, OR 97221-2545
Phone
(503) 894-9630
Fax
(833) 642-0439
NPI assigned
Sep 9, 2011
Last updated
Nov 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3858 OR Primary
Clinical Psychologist 103TC0700X 4874 CO

Addresses

Primary practice location

1750 SW Skyline Blvd Ste 201
Portland, OR 97221-2545

Mailing address

1750 SW Skyline Blvd Ste 201
Portland, OR 97221-2545
Phone (503) 894-9630

Other practice location 1

1750 SW Skyline Blvd Ste 201
Portland, OR 97221-2545
Phone (503) 894-9630

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4874COMDClinical Psychologist
3858ORMDHealth Service Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians Incorporated PastSince Dec 6, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1932481538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 SW SKYLINE BLVD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212545",
            "telephone_number": "503-894-9630",
            "fax_number": "833-642-0439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 SW SKYLINE BLVD STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972212545",
            "telephone_number": "503-894-9630",
            "fax_number": "833-642-0439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 SW Skyline Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972212545",
            "country_code": "US",
            "telephone_number": "503-894-9630",
            "fax_number": "833-642-0439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IZMIRIAN",
        "first_name": "SONIA",
        "middle_name": "C",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-09",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "3858",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "4874",
            "primary": false
        }
    ],
    "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 Nov 4, 2025; 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.