Loren E Mallory, PHD, ABPP

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

978 Issued in OR

Practice address

619 Madison St Ste 108
Oregon City, OR 97045-2354

Phone

(503) 303-4257

Fax

(503) 387-3957

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Willamette Falls Neuropsychology LLC

  • Clinical Neuropsychologist
  • Oregon City, OR
  • NPI 1316533979
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1992853402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 MADISON ST STE 108",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452354",
            "telephone_number": "503-303-4257",
            "fax_number": "503-387-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 MADISON ST STE 108",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970452354",
            "telephone_number": "503-303-4257",
            "fax_number": "503-387-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "LOREN",
        "middle_name": "E",
        "credential": "PHD, ABPP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "0978",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OR",
            "license": "978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN HMC",
            "identifier": "117227",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042544",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandy Jolene Maestas, CRM
• Magdalenne Corso, MD LLC
• Karl Magsarili, M.D.
• Polly Maliongas, DIPL. OM, LAC
• Mallory & White PC
• Tracy Mandel, MA, LPC, ATR
• Janet G. Mann, RDN
• Ashley Manning
• Britney E Manning
• Poorni Manchurekha Manohar, MD

• Clinical Neuropsychologist in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Clinical Neuropsychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.