CHARLES DAVID MAXEY (NPI# 1306234489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306234489 |
| Entity Type | Individual |
| Full Name | CHARLES DAVID MAXEY |
| Other Name | C. DAVID MAXEY |
| Credential | M.A. |
| Practice Address |
7145 Sw Varns St Ste 105 Portland OR 97223-8170 |
| Practice Telephone | 5039284182 |
| Mailing Telephone | 5039284182 |
| Enumeration Date | 2014-12-25 |
| Last Update Date | 2020-05-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | 5067 | OR | Behavioral Health & Social Service Providers |
| N | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
5067 | OR | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
5067 | OR | Behavioral Health & Social Service Providers |
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
5067 | OR | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2044 E Burnside St, Portland, OR 972141674 | 5039284182 | |
| 2408 Se 16th Ave, Portland, OR 972145334 | 5039284182 |
| Street Address |
7145 SW VARNS ST STE 105 |
| City | PORTLAND |
| State | OR |
| Zip Code | 97223-8170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
| 1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
| 1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
| 1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
| 1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
| 1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
| 1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
| 1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
| Find all providers in zip 97223 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912530643 | Positive Development for Youth and Families, Inc. | Psychologist | 4531 Se Belmont St Ste 110, Portland, OR 97215-1675 | 2020-02-21 |
| 1902440704 | Alicia Hoffman | Psychologist | 1577 Congress St Ste 2, Portland, ME 04102-2169 | 2019-11-05 |
| 1467819631 | Megan Nichols | Psychologist | 2734 Se 29th Ave, Apt B, Portland, OR 97202-1381 | 2016-01-19 |
| 1891043360 | Margaret Arnold Stoeckel | Psychologist | 5041 Se Taylor St, Portland, OR 97215-2624 | 2012-08-15 |
| 1851532139 | Charlene Eickholt | Psychologist | 1405 Ne Broadway, Suite # 200, Portland, OR 97232-1497 | 2009-03-16 |
| 1215081716 | Holly Linn Crossen | Psychologist | 1130 Sw Morrison St Ste 618, Portland, OR 97205-2217 | 2007-01-22 |
| 1972654697 | Nicholas John Ure | Psychologist | 101 Se 12th Ave, Portland, OR 97214-1319 | 2007-01-16 |
| 1528134772 | Marianne Michelle Kabour | Psychologist | 2801 N Gantenbein Ave Fl 3, Portland, OR 97227-1623 | 2006-11-28 |
| 1578588539 | Shirley May Hanson | Psychologist | 7912 Sw 35th Ave, Suite 6, Portland, OR 97219-2427 | 2006-07-12 |
| 1518904457 | Redmond Andrew Reams | Psychologist | 2106 Ne 40th Ave, Portland, OR 97212-5405 | 2006-05-31 |
| 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.