DR. BRIANNE PETRIE (NPI# 1295981256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295981256 |
| Entity Type | Individual |
| Full Name | DR. BRIANNE PETRIE |
| Credential | PSY.D. |
| Practice Address |
1815 Sw Marlow Ave Ste 218 Portland OR 97225-5187 |
| Practice Telephone | 5034444862 |
| Practice Fax Number | 5034444866 |
| Mailing Telephone | 5034444862 |
| Mailing Fax Number | 5034444866 |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2017-10-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2372 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | DMAP | 230442 | 01 |
| Street Address |
1815 SW MARLOW AVE STE 218 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97225-5187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275006546 | Monica Linder | Social Worker | 1815 Sw Marlow Ave Ste 218, Portland, OR 97225-5187 | 2019-01-09 |
| 1063937993 | Minkyeong Shin | Psychologist | 1815 Sw Marlow Ave Ste 218, Portland, OR 97225-5187 | 2017-08-11 |
| 1306387733 | Jennifer Foresman | Nurse Practitioner | 1815 Sw Marlow Ave Ste 218, Portland, OR 97225-5187 | 2017-03-18 |
| 1588107320 | Western Psychological and Counseling Services PC | Counselor | 1815 Sw Marlow Ave Ste 218, Portland, OR 97225-5187 | 2016-11-28 |
| 1851746796 | Heather A. Keizur | Marriage & Family Therapist | 1815 Sw Marlow Ave Ste 218, Portland, OR 97225-5187 | 2016-04-28 |
| 1669860383 | Janice Constantino | Counselor | 1815 Sw Marlow Ave Ste 218, Portland, OR 97225-5187 | 2015-01-05 |
| 1972738227 | Scott Anthony | Social Worker | 1815 Sw Marlow Ave Ste 218, Portland, OR 97225-5187 | 2009-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508425034 | Gabrielle Gonzales | Behavior Technician | 1675 Sw Marlow Ave, Suite 200, Portland, OR 97225 | 2019-06-08 |
| 1558844555 | Tate Roseberry | Behavior Technician | 1675 Sw Marlow Avenue, Suite 200, Portland, OR 97225 | 2018-09-14 |
| 1982186300 | Dean Alan Hopkins | Registered Nurse | 11782 Sw Barnes Rd, Suite 300, Portland, OR 97225 | 2018-09-01 |
| 1316449168 | Surgery Center At St. Vincent, LLC | Clinic/Center | 9135 Sw Barnes Rd Ste 161, Portland, OR 97225 | 2018-03-07 |
| 1730606716 | Meghan Louise Lacy | Pediatrics | 11790 Sw Barnes Rd, Blg. A, Suite 140, Portland, OR 97225 | 2017-08-29 |
| 1841733433 | Tia Pugh | Occupational Therapist | 9155 S.w. Barnes Road, East Pavilion, Portland, OR 97225 | 2016-11-30 |
| 1295185585 | Stephanie Lynn Hart | Nurse Practitioner | 9155 Sw Barnes Rd Ste 240, Portland, OR 97225 | 2016-06-16 |
| 1962866244 | Bejian Shamloo | Chiropractor | 10200 Sw Eastridge St., Suite 235, Portland, OR 97225 | 2016-04-12 |
| 1992162630 | Robert Joseph Yoder | Psychologist | 9045 Barnes Rd, Portland, OR 97225 | 2016-01-26 |
| 1316303951 | Katie Herold | Chiropractor | 9315 Sw Morrison St, Portland, OR 97225 | 2016-01-12 |
| Find all providers in zip 97225 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861007387 | Lyle Vintinner | Psychologist | 53 Baxter Blvd Ste 3, Portland, ME 04101-1827 | 2020-09-11 |
| 1194341297 | Natalie Dawn Mitchell | Psychologist | 3762 Sw Council Crest Dr, Portland, OR 97239-1595 | 2020-06-24 |
| 1992331607 | Erin A. Mueller | Psychologist | 718 Sw Alder St Ste 200, Portland, OR 97205-3423 | 2020-03-14 |
| 1952940520 | Timothy Allen Cooper | Psychologist | 3331 Sw Hamilton Ct, Portland, OR 97239-1256 | 2019-12-31 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1093373631 | Emily Catherine Stasko | Psychologist | 1950 Nw Raleigh St Apt 201, Portland, OR 97209-1775 | 2019-05-29 |
| 1174094544 | Juniper Psychological Services | Psychologist | 2827 Ne Alberta St, Portland, OR 97211-6350 | 2018-12-11 |
| 1528539335 | Mark G Kiefner Phd LLC | Psychologist | 225 Commercial St Ste 403, Portland, ME 04101-6603 | 2018-12-06 |
| 1467941831 | Shannon Madore | Psychologist | 3710 Sw Us Veterans Hospital Rd # R&d66, Portland, OR 97239-2964 | 2018-05-01 |
| 1033637202 | Kaylin Jones | Psychologist | 1235 Se Division Street, Suite 115, Portland, OR 97202-9720 | 2017-09-07 |
| Find all providers in PORTLAND | ||||
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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.