DR. CLAY FEDAK (NPI# 1750655817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750655817 |
| Entity Type | Individual |
| Full Name | DR. CLAY FEDAK |
| Credential | PSY.D. |
| Practice Address |
1120 Sw 3rd Ave Portland OR 97204-2828 |
| Mailing Address |
930 Nw 25th Pl Apt 108 Portland OR 97210-2873 |
| Practice Telephone | 6089576139 |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2019-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
1120 SW 3RD AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97204-2828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174590202 | Sandra J Mcallister | Nurse Practitioner | 1120 Sw 3rd Ave, 4th Floor, Portland, OR 97204-2801 | 2006-03-07 |
| 1407418999 | Multnomah County | Clinic/Center | 1120 Sw 3rd Ave, Detention Center, Portland, OR 97204-2828 | 2019-07-03 |
| 1780030650 | Mary Anna Gordon | Registered Nurse | 1120 Sw 3rd Ave, 4th Floor Medical, Portland, OR 97204-2828 | 2016-05-10 |
| 1497146286 | Angela Lee | Nurse Practitioner | 1120 Sw 3rd Ave, Portland, OR 97204-2828 | 2015-02-15 |
| 1912231606 | Melanie Jane Parker | Nurse Practitioner | 1120 Sw 3rd Ave, Portland, OR 97204-2801 | 2009-09-28 |
| 1073757316 | Multnomah County | Clinic/Center | 1120 Sw 3rd Ave, Dentention Center, Portland, OR 97204-2801 | 2009-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922662352 | Sleep Management, L.L.C. | Respiratory Therapist, Registered | 1050 Sw 6th Avenue, Suite 1100 Office # 52, Portland, OR 97204 | 2019-05-01 |
| 1588178701 | Daniel Hendrickson | Pharmacist | 503 Sw 5th Avenue, Portland, OR 97204 | 2017-11-27 |
| 1790133031 | Modupe Desiree Bansile | Counselor | 209 Sw Fourth Ave, Suite 520, Portland, OR 97204 | 2016-05-26 |
| 1841655834 | Isabella Zaragoza | Counselor | 421 Sw Oak St Suite 520, Portland, OR 97204 | 2015-12-18 |
| 1952737736 | Hessler-cohen Enterprises LLC | Acupuncturist | 310 Sw 4rth Avenue, Suite 725, Portland, OR 97204 | 2013-09-24 |
| 1144583378 | Angela Nicole Johnson | Physical Therapist | 555 Sw Oak Street, Portland, OR 97204 | 2012-06-22 |
| 1255614624 | Jaclyn Rene Jones | Nurse Practitioner | 601 Sw 4th Ave, Portland, OR 97204 | 2011-09-22 |
| 1407148398 | Cristianne Paulsen | Dental Hygienist | 426 Sw Stark, 9th Floor, Portland, OR 97204 | 2011-05-10 |
| 1396928255 | Jessica L Hall | Counselor | 421 Sw Oak Street, Suite 520, Portland, OR 97204 | 2007-12-13 |
| 1699896274 | Julie Anne Oyemaja | Counselor | 421 Sw Oak St., Ste. 210, Portland, OR 97204 | 2007-04-02 |
| Find all providers in zip 97204 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748243 | Jessica M Feinsmith | Counselor | 6530 N Williams Ave, Portland, OR 97217-1924 | 2020-10-21 |
| 1720687809 | Karissa Myriah Gregory | Counselor | 14255 Se Rupert Dr, Portland, OR 97267-1211 | 2020-10-20 |
| 1528667904 | Zuzana Sakova | Counselor | 819 Se Morrison St Ste 225, Portland, OR 97214-6311 | 2020-10-18 |
| 1891302238 | Nina Landey | Counselor | 120 Se 53rd Ave, Portland, OR 97215-1204 | 2020-09-29 |
| 1902412166 | Peter H Addy LLC | Counselor | 524 N Tillamook St Ste 102b, Portland, OR 97227-1993 | 2020-09-22 |
| 1326654765 | Naomi Painter | Counselor | 1925 Ne 19th Ave Apt 8a, Portland, OR 97212-4526 | 2020-09-21 |
| 1750996104 | Sara Fuller | Counselor | 3016 Ne 70th Ave, Portland, OR 97213-5802 | 2020-09-12 |
| 1114532983 | Matthew W Cronin | Counselor | 1122 Ne 122nd Ave Ste 200, Portland, OR 97230-2081 | 2020-09-09 |
| 1447865381 | Luke Colbourn | Counselor | 2705 E Burnside St Ste 206, Portland, OR 97214-1768 | 2020-09-08 |
| 1710599774 | Abigail Kathryn Ernst | Counselor | 1020 Sw Taylor St # 100, Portland, OR 97205-2543 | 2020-08-20 |
| 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.