Individual provider Active NPI

Zachary Gibson Buckles, PSY.D.

  • Psychologist
  • Tigard, OR
National Provider Identifier
1932747789
Registry record updated May 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3772 Issued in OR
Practice address
7340 SW Hunziker Rd Ste 210
Tigard, OR 97223-2304
Phone
(503) 352-0036
Fax
(503) 352-0040
NPI assigned
Dec 11, 2019
Last updated
May 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3772 OR Primary

Addresses

Primary practice location

7340 SW Hunziker Rd Ste 210
Tigard, OR 97223-2304

Mailing address

7340 SW Hunziker Rd Ste 210
Tigard, OR 97223-2304
Phone (503) 352-0036

Other practice location 1

1901 N Esther St
Newberg, OR 97132-9529
Phone (855) 512-3909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250618000084 OR Practitioner - Clinical Psychologist 7214448034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cornerstone Clinical Services PCGroup PAC ID 3274523378, 16 clinicians

Practice addresses (Care Compare)

7340 SW Hunziker Rd
Suite 210
Tigard, OR 97223-2304
Phone (503) 352-0036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3772ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Clinical Services PC CurrentSince May 23, 2025 Accepting new patients
Cornerstone Clinical Services, Inc CurrentSince May 23, 2025 Accepting new patients
George Fox University PastSince Dec 1, 2019 Accepting new patients

Locations

6400 SE Lake Rd
Ste 325
Portland, OR 97222
Phone (503) 786-1711

7340 SW Hunziker Rd
Ste 210
Tigard, OR 97223
Phone (503) 352-0036

Organizations & group practices 3

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": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746921600000",
    "number": "1932747789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7340 SW HUNZIKER RD STE 210",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232304",
            "telephone_number": "503-352-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7340 SW HUNZIKER RD STE 210",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972232304",
            "telephone_number": "503-352-0036",
            "fax_number": "503-352-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 N Esther St",
            "address_purpose": "LOCATION",
            "city": "Newberg",
            "state": "OR",
            "postal_code": "971329529",
            "country_code": "US",
            "telephone_number": "855-512-3909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKLES",
        "first_name": "ZACHARY",
        "middle_name": "GIBSON",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-11",
        "last_updated": "2025-05-11",
        "certification_date": "2025-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "3772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.