NPI 1053453050 · live from the CMS NPI Registry
Renata A Ackermann, PhD
Psychologist, Clinical in Portland, OR. National Provider Identifier 1053453050, active.
NPI record
| NPI | 1053453050 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 619 Nw 6th Ave, Portland, OR 97209 |
| Practice phone | 503-988-3700 |
| Enumerated | February 13, 2007 |
| Last updated | April 10, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | 1777 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.