KIMBERLY WISOTZKE (NPI# 1336578665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336578665 |
| Entity Type | Individual |
| Full Name | KIMBERLY WISOTZKE |
| Practice Address |
5440 Sw Westgate Dr Ste 175 Portland OR 97221-2420 |
| Practice Telephone | 9712315519 |
| Mailing Telephone | 9712315519 |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2015-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
Behavioral Health & Social Service Providers |
| Street Address |
5440 SW WESTGATE DR STE 175 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97221-2420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275531055 | Chris James Lampert | Dentist | 5440 Sw Westgate Dr, Suite 300, Portland, OR 97221-2420 | 2005-07-14 |
| 1366073405 | Aimee Nicole Renteria | Massage Therapist | 5440 Sw Westgate Dr, Portland, OR 97221-2420 | 2020-01-28 |
| 1821445230 | Tessie Mcduffie | Dental Hygienist | 5440 Sw Westgate Dr, #165, Portland, OR 97221-2420 | 2016-05-16 |
| 1538567169 | Renew Health and Wellness LLC | Clinic/Center | 5440 Sw Westgate Dr, Suite 100, Portland, OR 97221-2420 | 2014-12-14 |
| 1437572369 | Hearing Rehab Center West Hills LLC | Audiologist | 5440 Sw Westgate Dr, Ste 350, Portland, OR 97221-2447 | 2014-01-29 |
| 1114355500 | Flourish Natural Medicine LLC | Family Medicine | 5440 Sw Westgate Dr, Ste 245, Portland, OR 97221-2420 | 2013-10-22 |
| 1477891547 | Jessica Anderson | Naturopath | 5440 Sw Westgate Dr, Suite 245, Portland, OR 97221-2420 | 2013-01-24 |
| 1104094432 | Sylvan Chiropractic Clinic, LLC | Chiropractor | 5440 Sw Westgate Dr, Suite 100, Portland, OR 97221-2420 | 2008-02-20 |
| 1790999316 | Dentistry for Children, P.C. | Dentist | 5440 Sw Westgate Dr, Suite 380, Portland, OR 97221-2420 | 2007-05-10 |
| 1568596591 | Antonia Forster | Clinical Neuropsychologist | 5440 Sw Westgate Dr, Suite 175, Portland, OR 97221-2420 | 2007-03-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460371 | Samantha Nozomi Murata | Pharmacist | 5415 Sw Beaverton Ct Hwy, Portland, OR 97221 | 2020-09-08 |
| 1063996312 | Maximilian Torres | Physical Therapy Assistant | 4602 Sw 53rd Ave, Portland, OR 97221 | 2018-09-22 |
| 1275071599 | Kayla Hoskins | Social Worker | 6443 Sw Beaverton Hillsdale Hwy Suite 300, Portland, OR 97221 | 2017-02-07 |
| 1467821520 | Tam Nguyen | Pharmacist | 5431 Sw Beaverton Hillsdale, Portland, OR 97221 | 2015-09-18 |
| 1124494786 | Laine Towell | Psychologist | 6443 Sw Beaverton Hillsdale Hwy Ste 300, Portland, OR 97221 | 2015-08-18 |
| 1376936633 | Patricia A. Lolich-beyer | Counselor | 5201 Sw Westgate Dr., Suite 118, Portland, OR 97221 | 2015-03-11 |
| 1134468374 | Alexandra Scamarone | Acupuncturist | 5319 Sw Westgate Dr, Unit No. 150, Portland, OR 97221 | 2013-02-07 |
| 1508118316 | Nichole C. Marks | Speech-Language Pathologist | 6125 Sw Boundary, Portland, OR 97221 | 2012-10-04 |
| 1649529538 | Navkiran Kaur Singh | Counselor | 5440 Sw Westgate Drive., Suite 175, Portland, OR 97221 | 2012-09-06 |
| 1306124276 | Alyssa C. Brin | Counselor | 5440 Sw Westgate Dr Ste 210, Portland, OR 97221 | 2011-07-26 |
| Find all providers in zip 97221 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740616325 | Kathleen Gregorich Hoffman | Psychologist | 3245 Nw Thurman St, Portland, OR 97210-1224 | 2013-09-16 |
| 1558708461 | Anthony Michael Duncan | Psychologist | 2236 Se Belmont St, Portland, OR 97214-2817 | 2013-05-31 |
| 1083998611 | Kaufman Psychological Services | Psychologist | 1321 Washington Ave Ste 102, Portland, ME 04103-3636 | 2011-09-30 |
| 1174813539 | Robert W Mclellarn, Phd | Psychologist | 5440 Sw Westgate Drive, Suite 175, Portland, OR 97221 | 2011-04-19 |
| 1346574449 | Jerusha Beth Detweiler-bedell | Psychologist | 5440 Sw Westgate Dr., #175, Portland, OR 97221-2436 | 2009-09-23 |
| 1386845048 | Morris Tiktin | Psychologist | 1201 Sw 12 Ave, Suite 300, Portland, OR 97205-2046 | 2007-05-30 |
| 1235341629 | Muriel D. Lezak | Psychologist | 2211 Sw 1st Ave, G10, Portland, OR 97201-5060 | 2007-05-05 |
| 1952528952 | Melisa L. Finch | Psychologist | 10201 Se Main St Ste 10, Portland, OR 97216-2937 | 2007-04-19 |
| 1992712103 | Maryann J Carroll | Psychologist | 25 Bedell St, Portland, ME 04103-1705 | 2006-08-01 |
| 1588642953 | Joseph Peter Gretsch | Psychologist | 818 Sw 3rd Ave, #148, Portland, OR 97204-2405 | 2006-01-05 |
| 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.