DR. COREY DARRYL ANDERSON PSY.D.
NPI 1114278819
Clinical Neuropsychologist in Portland, OR

Q: What is Corey Anderson's NPI number?

The NPI number for Corey Anderson is 1114278819. It was assigned to this individual provider in the NPPES registry on September 21, 2012.

Q: What is Corey Anderson's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Q: When was this NPI record last updated?

The NPPES record for Corey Anderson was last updated on March 22, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.

Active since September 21, 2012PECOS Enrolled

2801 N GANTENBEIN AVE, SUITE 2225, PORTLAND, OR 97227(503) 413-4505(503) 413-3063 Get Directions Write a Review

NPPES record last updated: March 22, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Corey Darryl Anderson Psy.d. NPPES

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

DR. COREY DARRYL ANDERSON PSY.D. (NPI 1114278819) is an individual clinical neuropsychologist in Portland, Oregon, licensed in Oregon (2325) and active in the NPI registry since September 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114278819

Entity TypeIndividualMale

Primary Taxonomy103G00000X

Provider Legal NameDR. COREY DARRYL ANDERSONCredential: PSY.D.

Location Address2801 N GANTENBEIN AVE, SUITE 2225Portland, OR 97227-1623

Mailing Address2801 N Gantenbein Ave, Suite 2225Portland, OR 97227-1623 · (503) 413-4505 · Fax (503) 413-3063

Phone(503) 413-4505

Fax(503) 413-3063

Sole ProprietorNo

Enumeration DateSeptember 21, 2012

Last NPPES UpdateMarch 22, 2017

✔ NPI 1114278819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers

Taxonomy Code103G00000X

License✔ Licensed in OR · 2325

Definition

A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.

2801 N GANTENBEIN AVE, Portland, OR 97227

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Corey Darryl Anderson Psy.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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