Northwest Dbt LLC
Psychologist (Clinical)

Address: 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210
Phone: 5039636540

Northwest Dbt LLC (NPI# 1215574058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1215574058
Entity Type Organization
Organization Name NORTHWEST DBT LLC
Practice Address 2230 Nw Pettygrove St.
Suite 130
Portland
OR 97210
Practice Telephone 5039636540
Practice Fax Number 8889658362
Mailing Address 2230 Nw Pettygrove St.
Suite 130
Portland
OR 97210
Mailing Telephone 5039636540
Mailing Fax Number 8889658362
Authorized Official Name Tracy Marie Jendritza (PROGRAM DIRECTOR)
Authorized Official Telephone 5039636540
Authorized Official Credential PSY.D.
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2019-11-27
Last Update Date 2019-11-27

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 103TC0700X Psychologist · Clinical Behavioral Health & Social Service Providers

Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth — one that is broadly inclusive of severe psychopathology — and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Notes: Source: American Psychological Association, www.apa.org [1/1/2019: new definition]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
1457889545 Robert Adam Dickey Psychologist 818 Nw 17th Ave Ste 9, Portland, OR 97209-2327 2017-06-01
1033646484 Stephen James Boyd Psychologist 1742 Se Clatsop St, Portland, OR 97202-7305 2017-05-16
1194260505 Jennifer Dahlin Psychologist 3926 Ne 38th Ave, Portland, OR 97212-1845 2016-12-21
1578019113 Lydia Ward-gray, Psyd, LLC Psychologist 19 South Street, Suite 4, Portland, ME 04101 2016-09-01
1912368614 Laura Krumins Psychologist 1220 Sw Morrison St Ste 929, Portland, OR 97205-2228 2016-03-09
1992162630 Robert Joseph Yoder Psychologist 9045 Barnes Rd, Portland, OR 97225 2016-01-26
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Office Location

Street Address 2230 NW PETTYGROVE ST.
SUITE 130
City PORTLAND
State OR
Zip Code 97210

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NPI Name Taxonomy Address Enumeration
1649769480 Dipesh Patel Student in an Organized Health Care Education/Training Program 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 2018-05-08
1194227942 Rachel Lynn Koski Student in an Organized Health Care Education/Training Program Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 2018-03-07
1205349172 Paul M Storm Acupuncturist 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 2017-11-14
1740703750 Audra K Berning Massage Therapist 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 2017-07-21
1720539810 Anna-marie Elizabeth Wood Audiologist 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 2016-10-24
1659829836 H&s Pearl, LLC Massage Therapist 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 2016-09-15
1255785796 Cortez Natural Medicine, Inc. Acupuncturist 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 2016-04-21
1932563616 Vincent Chen Student in an Organized Health Care Education/Training Program 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 2016-04-08
1164899373 Root & Branch Physical Therapy Physical Therapist 2232 Nw Pettygrove St, Ste 110, Portland, OR 97210 2015-08-24
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Competitor

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City PORTLAND
Zip Code 97210

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Dataset Information

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.

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