Christopher Jay Lundell

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60936143 Issued in WA

Practice address

4004 NE 77TH Ave
Portland, OR 97213-6438

Phone

(971) 227-5063

NPI assigned

Jun 7, 2017

Last updated

Feb 28, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 12, 2020 through Feb 12, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• A Better Way Counseling Service

  • Mental Health Counselor
  • Vancouver, WA
  • NPI 1265877310
  NPD (past)

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582848000000",
    "number": "1972032548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 NE 77TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 NE 77TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972136438",
            "telephone_number": "971-227-5063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDELL",
        "first_name": "CHRISTOPHER",
        "middle_name": "JAY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60936143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Kay Lundberg, FNP
• James Robert Lundblad, MD, PHD
• Duane Allen Lundeberg, MD
• Matthew Lundeberg, PSYD
• Megan Rose Lundeberg, M.D.
• Martin Gates Lundell
• Nathalie Lunden, M.D.
• Brianna Leanne Lundgren
• Eli Lundgren
• Gary Duane Lundgren, RPH

• Clinical Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.