Organization Active NPI

Richard Kolbell, PHD, PC

  • Clinical Neuropsychologist
  • Portland, OR
National Provider Identifier
1982996179
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1084 Issued in OR
Legal business name
RICHARD KOLBELL, PHD, PC
Practice address
1923 NE Broadway St
Portland, OR 97232-1501
Phone
(503) 284-2371
NPI assigned
May 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Authorized official

Name
Dr. Richard Kolbell, PHD
Title
Owner
Phone
(503) 284-2372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 1084 OR Primary

Addresses

Primary practice location

1923 NE Broadway St
Portland, OR 97232-1501

Mailing address

1923 NE Broadway St
Portland, OR 97232-1501
Phone (503) 284-2371

Other identifiers 1

IdentifierTypeStateIssuer
123823OtherOROREGON STATE DEPARTMENT OF HUMAN SERVICES

National Provider Directory

National Provider Directory

Locations

1923 NE Broadway St
Portland, OR 97232
Phone (503) 284-2371

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304640000000",
    "number": "1982996179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321501",
            "telephone_number": "503-284-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 NE BROADWAY ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972321501",
            "telephone_number": "503-284-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD KOLBELL, PHD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "last_updated": "2011-05-06",
        "status": "A",
        "authorized_official_last_name": "KOLBELL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-284-2372",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "1084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE DEPARTMENT OF HUMAN SERVICES",
            "identifier": "123823",
            "state": "OR"
        }
    ],
    "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 May 6, 2011; 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.