PSYCHOLOGICAL SERVICES CENTER, P.C. (NPI# 1023408341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023408341 |
| Entity Type | Organization |
| Organization Name | PSYCHOLOGICAL SERVICES CENTER, P.C. |
| Practice Address |
1800 Blankenship Rd Ste 200 West Linn OR 97068-4174 |
| Practice Telephone | 9714005544 |
| Mailing Telephone | 9714005544 |
| Enumeration Date | 2015-01-24 |
| Last Update Date | 2015-01-24 |
| Authorized Official Name | DR. TERRENCE WAGER (OWNER) |
| Authorized Official Telephone | 9714005544 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
2220 | OR | Behavioral Health & Social Service Providers |
| Street Address |
1800 BLANKENSHIP RD STE 200 |
| City | WEST LINN |
| State | OR |
| Zip Code | 97068-4174 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316240583 | David Robert Gleave | Psychologist | 1800 Blankenship Rd Ste 200, West Linn, OR 97068 | 2010-12-10 |
| 1639634009 | Dana Jones Pmhnp LLC | Clinic/Center | 1800 Blankenship Rd Ste 200, West Linn, OR 97068-4174 | 2019-02-09 |
| 1750856084 | David Robert Gleave, Psyd, LLC | Clinic/Center | 1800 Blankenship Rd Ste 200, West Linn, OR 97068-4174 | 2018-10-13 |
| 1568947828 | Tanya Marie Gore | Counselor | 1800 Blankenship Rd Ste 200, West Linn, OR 97068-4174 | 2018-10-02 |
| 1982107264 | Megan M Geary | Social Worker | 1800 Blankenship Rd Ste 200, West Linn, OR 97068 | 2018-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023678224 | Bethany Joy Bivin | Registered Nurse | 2020 8th Ave Ste 230, West Linn, OR 97068 | 2019-06-19 |
| 1932612777 | Portland Dental Works, LLC | Dentist | 1750 Mckillican, West Linn, OR 97068 | 2017-11-15 |
| 1316460702 | Cameron Johnson Dc LLC | Chiropractor | 21400 Salamo Rd, West Linn, OR 97068 | 2017-07-18 |
| 1376913301 | Genesis Medical Concepts, LLC | Durable Medical Equipment & Medical Supplies | 2020 8th Ave Ste 222, West Linn, OR 97068 | 2015-10-02 |
| 1780052977 | Amanda Carole Tipton | Chiropractor | 21860 Willamette Drive, West Linn, OR 97068 | 2015-09-04 |
| 1457766859 | Eyedeology, Inc | Optometrist | 5656 Hood St. Ste 107, West Linn, OR 97068 | 2014-06-24 |
| 1740694660 | Ariana Bissinger | Nurse Practitioner | 1148 Rosemont Rd, West Linn, OR 97068 | 2014-06-18 |
| 1154606887 | Heather Marie Ellison | Massage Therapist | 22000 Willamette Dr., #107, West Linn, OR 97068 | 2011-10-13 |
| 1336432616 | Lisa Grage | Dental Hygienist | 3551 Coeur D'alene Dr., West Linn, OR 97068 | 2011-05-19 |
| 1922312149 | Richard Barrett King | Behavioral Analyst | 19890 Roan Circle, West Linn, OR 97068 | 2010-07-29 |
| Find all providers in zip 97068 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366776841 | Kameron Candace Dill | Psychologist | 21900 Willamette Dr Ste 202, West Linn, OR 97068-3284 | 2009-09-30 |
| 1346439783 | Kristin Valerius | Psychologist | 21900 Willamette Dr Ste 202, West Linn, OR 97068-3284 | 2007-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912530643 | Positive Development for Youth and Families, Inc. | Psychologist | 4531 Se Belmont St Ste 110, Portland, OR 97215-1675 | 2020-02-21 |
| 1467819631 | Megan Nichols | Psychologist | 2734 Se 29th Ave, Apt B, Portland, OR 97202-1381 | 2016-01-19 |
| 1699161745 | Nvw Newco | Psychologist | 160 Scalehouse Loop, Suite 160, Bend, OR 97702-1284 | 2015-04-15 |
| 1538412549 | Daniel Kriz | Psychologist | Ne 2542 Courtney Drive, Bend, OR 97701 | 2012-10-16 |
| 1891043360 | Margaret Arnold Stoeckel | Psychologist | 5041 Se Taylor St, Portland, OR 97215-2624 | 2012-08-15 |
| 1629305545 | Cynthia Marie Anderson | Psychologist | 2085 Sunrise Blvd, Eugene, OR 97405-5524 | 2009-11-13 |
| 1780815811 | Kristen Heather Marcaly | Psychologist | 14025 Sw Farmington Rd Ste 160, Beaverton, OR 97005 | 2009-08-06 |
| 1851532139 | Charlene Eickholt | Psychologist | 1405 Ne Broadway, Suite # 200, Portland, OR 97232-1497 | 2009-03-16 |
| 1497904924 | Ian Alexander Shinney | Psychologist | 2611 Erin Way, Eugene, OR 97408-4713 | 2008-09-09 |
| 1316092349 | Whitney Vail | Psychologist | 2450 Strong Rd Se, Salem, OR 97302-9676 | 2007-01-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.