Unknown Individual – Clinical Psychologist, NPI 1396830832

Unknown Individual is a healthcare provider. based in Portland, Oregon. specializing in Clinical Psychologist. They hold a License No. 244 (OR). The NPI Number for Unknown Individual is 1396830832

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396830832
Phone
(503) 221-1379
Address
1088 NE 7TH AVE APT 610
Deactivation Date
6 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5032211379
Graduation Year
1973 (53 years ago)
PAC ID
9335226893
Professional Enrollment ID
I20080408000390
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience33
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1088 NE 7TH AVE APT 610

    PORTLAND, OR 972323627

    Phone: (503) 221-1379

    Type: Mailing

  • 1817 E Springfield Ave

    Suite E

    Spokane, WA 992022913

    Phone: (509) 389-1494

    Fax: (509) 535-4069

    Type: Location

  • Southeast Alder Street, Russellville, Mill Park, Portland, Metro, Multnomah County, Oregon, 97216, United States

    PORTLAND, OR 972142400

    Phone: (503) 221-1379

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97232)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1396830832.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Clinical Psychologist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Portland, Oregon in our summary view.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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