Individual provider Active NPI

Tyler Cole Duffield, PHD

  • Clinical Psychologist
  • Portland, OR
National Provider Identifier
1962842203
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2971 Issued in OR
Practice address
9155 SW Barnes Rd Ste 333
Portland, OR 97225-6630
Phone
(503) 216-5102
NPI assigned
Jul 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2971 OR Primary

Addresses

Primary practice location

9155 SW Barnes Rd Ste 333
Portland, OR 97225-6630

Mailing address

PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494

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
I20180904000692 OR Practitioner - Clinical Psychologist 9537419098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

9155 SW Barnes Rd
Suite 333
Portland, OR 97225-6630
Phone (503) 216-5102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2971ORMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services - Oregon CurrentSince Jan 15, 2024 Accepting new patients
Providence Health & Services Oregon CurrentSince Jan 15, 2024 Accepting new patients

Locations

9155 SW Barnes Rd
Ste 333
Portland, OR 97225
Phone (503) 216-2028

5050 NE Hoyt St
Ste 240
Portland, OR 97213
Phone (503) 215-6480

5228 NE Hoyt St
Bldg B
Portland, OR 97213
Phone (503) 215-4860

1321 NE 99th Ave
Ste 200
Portland, OR 97220
Phone (503) 215-4250

Interoperability endpoints

  • Direct secure messaging: tduffield3112099@oc.providencedirect.org

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": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1962842203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9155 SW BARNES RD STE 333",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256630",
            "telephone_number": "503-216-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFFIELD",
        "first_name": "TYLER",
        "middle_name": "COLE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.