SUSAN ELMORE (NPI# 1770573354) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770573354 |
| Entity Type | Individual |
| Full Name | SUSAN ELMORE |
| Credential | MD |
| Practice Address |
1631 Sw Columbia St Portland OR 97201-6025 |
| Mailing Address |
1776 Sw Madison St Portland OR 97205-1715 |
| Practice Telephone | 5032312641 |
| Practice Fax Number | 5032611654 |
| Mailing Telephone | 5032312641 |
| Mailing Fax Number | 5032311654 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | MD19811 | OR | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 126370 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114106804 | Susan B Elmore | Clinical Nurse Specialist | 3101 Broadway Blvd, Kansas City, MO 64111-2659 | 2007-10-30 |
| 1215904727 | Susan G. Elmore | Nurse Anesthetist, Certified Registered | 100 N Academy Ave, Danville, PA 17822-2025 | 2006-03-02 |
| Street Address |
1631 SW COLUMBIA ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97201-6025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740897933 | Lori A Bradford | Counselor | 1631 Sw Columbia St, Portland, OR 97201-6025 | 2020-09-30 |
| 1407488851 | Sheila S Andrews | Counselor | 1631 Sw Columbia St, Portland, OR 97201-6025 | 2020-02-04 |
| 1003450248 | Amber C Lewis | Counselor | 1631 Sw Columbia St, Portland, OR 97201-6025 | 2019-10-31 |
| 1376193201 | Candi L Balabon | Counselor | 1631 Sw Columbia St, Portland, OR 97201-6025 | 2019-09-12 |
| 1013560713 | Nicole Marie Williams | Counselor | 1631 Sw Columbia St, Portland, OR 97201-6025 | 2019-07-22 |
| 1720631435 | Isabel M Hartshorn | Counselor | 1631 Sw Columbia St, Portland, OR 97201-6025 | 2019-07-22 |
| 1487113262 | Rebecca J Johnson | Counselor | 1631 Sw Columbia St, Portland, OR 97201-6025 | 2019-03-19 |
| 1447760608 | Kelli A Cunningham | Counselor | 1631 Sw Columbia St, Portland, OR 97201-6025 | 2017-10-02 |
| 1013430271 | Jessica L Spain | Counselor | 1631 Sw Columbia St, Portland, OR 97201-6025 | 2017-07-19 |
| 1932635828 | Rose I Hill | Counselor | 1631 Sw Columbia St, Portland, OR 97201-6025 | 2017-05-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206060 | Laura Elizabeth Jackson | Student in an Organized Health Care Education/Training Program | 2730 S Moody Ave, Portland, OR 97201 | 2020-05-10 |
| 1225659063 | Amanpreet Kaur | Student in an Organized Health Care Education/Training Program | Ohsu Physician Assistant Program, 2730 South Moody Ave. Mail Code: Cl5pa, Portland, OR 97201 | 2020-05-04 |
| 1063033801 | Aaron Kinn | Student in an Organized Health Care Education/Training Program | Ohsu Division of Physician Assistant Education - Cl5pa, 2730 Sw Moody Avenue, Portland, OR 97201 | 2020-05-04 |
| 1487275442 | Erin Aleen Ostlie-madden | Student in an Organized Health Care Education/Training Program | 2730 South Moody Ave, Portland, OR 97201 | 2020-04-30 |
| 1104446681 | Skycloud Psychiatry LLC | Nurse Practitioner | 106 South West Woods St, Portland, OR 97201 | 2020-04-24 |
| 1740825587 | Dalia Bayaa | Pharmacist | 325 Sw Harrison Street, Portland, OR 97201 | 2019-11-15 |
| 1780172619 | Susan Elizabeth Christian Barrios | Social Worker | 1505 Sw College St, Portland, OR 97201 | 2018-04-26 |
| 1730696576 | Fiona Everett | Counselor | 1703 Sw Clay St, Portland, OR 97201 | 2018-01-02 |
| 1437678844 | Akira Thomas Neilsen | Student in an Organized Health Care Education/Training Program | 1930 Sw River Drive, Unit 102, Portland, OR 97201 | 2017-09-18 |
| 1285171736 | Howard Mitchell | Technician, Other | 1110 Sw Clay Street Apt. 34, Portland, OR 97201 | 2017-01-23 |
| Find all providers in zip 97201 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508466574 | Jessica Michelle Simonetti | Psychologist | Portland Psychotherapy Clinic, Research and Training Ce, 3700 N Williams Ave, Portland, OR 97227 | 2020-10-29 |
| 1811518434 | Nathaniel Israel | Psychologist | 7419 Se Woodstock Blvd, Portland, OR 97206-5838 | 2020-05-05 |
| 1477112480 | Stella Beatriz Kerl-mcclain | Psychologist | 2826 Sw Ridge Dr, Portland, OR 97219-6205 | 2019-06-12 |
| 1184281438 | Nicholas Alexander Schollars | Psychologist | 3050 Se Division St # 215, Portland, OR 97202-1451 | 2019-05-22 |
| 1639637432 | Bayside Psychology and Consulting, LLC | Psychologist | 1 Union St Ste 402, Portland, ME 04101-4048 | 2019-03-11 |
| 1942766985 | Alexandra R. Lash | Psychologist | 386 Fore St, Portland, ME 04101-4047 | 2019-02-14 |
| 1811416068 | Matthew Lundeberg | Psychologist | 10300 Sw Greenburg Rd Ste 271, Portland, OR 97223-5415 | 2017-09-19 |
| 1083130991 | Tawayne Nolen Malone Jr. | Psychologist | 0615 Sw Palatine Hill Road, Tawayne Malone - Msc 2159, Portland, OR 97219 | 2017-08-22 |
| 1093241838 | Dr Patricia Clark | Psychologist | 1132 Sw 19th Ave, Portland, OR 97205-1740 | 2017-05-11 |
| 1639527575 | Randall David Wright | Psychologist | 1827 Ne 44th Ave Ste 320, Portland, OR 97213-1443 | 2016-06-01 |
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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.