DR. CHARLENE EICKHOLT


Address: 1405 Ne Broadway, Suite # 200, Portland, OR 97232-1497
Phone: 5032885516

DR. CHARLENE EICKHOLT (NPI# 1851532139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851532139
Entity Type Individual
Full Name DR. CHARLENE EICKHOLT
Other Name DR. CHAR EICKHOLT
Credential PH.D.
Practice Address 1405 Ne Broadway
Suite # 200
Portland
OR 97232-1497
Practice Telephone 5032885516
Mailing Telephone 5032885516
Enumeration Date 2009-03-16
Last Update Date 2009-03-16
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC2200X Psychologist
Specialization: Clinical Child & Adolescent
PSY1323 OR Behavioral Health & Social Service Providers

Office Location

Street Address 1405 NE BROADWAY
SUITE # 200
City PORTLAND
State OR
Zip Code 97232-1497

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1194285411 Onampai Modina Soondarotok Student in an Organized Health Care Education/Training Program Ipp, Oregon Health & Science University, 2214 Lloyd Center, Portland, OR 97232 2019-03-22
1003399635 Cathleen Nicole Wenberg Social Worker 1839 Ne Couch St, Portland, OR 97232 2018-09-10
1508350760 Float North Acupuncturist 1617 Ne 17th Ave., Portland, OR 97232 2018-06-20
1629560719 Rachael Lee Walters Doula 3005 Ne Hoyt St, Portland, OR 97232 2018-06-04
1225529431 Jason Sutherland Social Worker 707 Ne Couch, Portland, OR 97232 2018-05-23
1770089245 Richard Farwell Leman Family Medicine 800 Ne Oregon St., Suite 772, Portland, OR 97232 2018-04-03
1952803413 Aleksandra Giedowyn Md PC Family Medicine 1923 Ne Broadway Street Suite 2, Portland, OR 97232 2018-03-01
1639680374 Amanda Matteo Counselor 20 Ne 10th Ave, Portland, OR 97232 2017-10-20
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Taxonomy Information

Taxonomy Code 103TC2200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical Child & Adolescent

Taxonomy Definition

Definition to come...
Notes: [1/1/2007: title modified]

Providers in the same taxonomy and city

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
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
1285259952 Alexandra Pachter Psychologist 1411 Sw Morrison St Ste 310, Portland, OR 97205-1945 2020-06-09
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Competitor

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City PORTLAND
Zip Code 97232

Improve Information

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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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