MARY NICHOLS
NPI 1053517110
Psychologist in Portland, OR

Active since June 26, 2007
1133 NW 21ST AVE, PORTLAND, OR 97209(503) 222-5010 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mary Nichols NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY NICHOLS (NPI 1053517110) is an individual psychologist in Portland, Oregon, licensed in Oregon (0949) and active in the NPI registry since June 2007.

NPPES Registry Identity

NPI1053517110
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameMARY NICHOLS
Location Address1133 NW 21ST AVEPortland, OR 97209-1513
Mailing Address1133 Nw 21st AvePortland, OR 97209-1513
Sole ProprietorYes
Enumeration DateJune 26, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1053517110 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in OR · 0949
Definition
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.
1133 NW 21ST AVE, Portland, OR 97209

Other Identifiers 1

Medicare ID-Type Unspecified0000TCHNXOR

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
1133 NW 21ST AVE, SUITE 204
PORTLAND, OR 97209
Psychologist
1133 NW 21ST AVE
PORTLAND, OR 97209
Psychologist (Clinical)
1133 NW 21ST AVE, SUITE 203
PORTLAND, OR 97209
Counselor (Professional)
1133 NW 21ST AVE, SUITE 201
PORTLAND, OR 97209
Counselor (Mental Health)
1133 NW 21ST AVE
PORTLAND, OR 97209
Psychologist (Clinical)
1133 NW 21ST AVE
PORTLAND, OR 97209
Psychologist
1133 NW 21ST AVE
PORTLAND, OR 97209
Psychologist (Clinical)
1133 NW 21ST AVE
PORTLAND, OR 97209

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Nichols's NPI number?

The NPI number for Mary Nichols is 1053517110. It was assigned to this individual provider in the NPPES registry on June 26, 2007.

Where is Mary Nichols located?

Mary Nichols practices at 1133 NW 21st Ave, Portland, OR 97209. The listed phone number is (503) 222-5010.

What is Mary Nichols's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

When was this NPI record last updated?

The NPPES record for Mary Nichols was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.