Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Dr. Chanel Breae Dismuke , PsyD

Psychologist β€’ Beaverton, OR

Active NPI 1780053314 Individual Practitioner Female Practitioner
Practice location in NPPES

1975 Nw 167th Pl Ste 100-42
Beaverton, OR 970064908

Call 5034365663 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1975 Nw 167th Pl Ste 100-42

Beaverton, OR 970064908

Telephone 5034365663
Organization at the Same NPPES Address or Phone
Nw Intrinsic Psychotherapy Facility NPI 1770369480

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Beaverton, OR. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2015

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Beaverton and Oregon

23 active clinicians are listed under Psychologist with a practice address in Beaverton, OR (742 in Oregon).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Beaverton

21.7% of these 23 clinicians have the CMS telehealth indicator.

21.7% of these 23 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2024-07-04
Psychologist Primary Specialty

NUCC Taxonomy Code: 103T00000X

License # reported to NPPES OR 3292

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.

Psychologist - Cognitive & Behavioral

NUCC Taxonomy Code: 103TB0200X

A psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking.

Psychologist - Clinical

NUCC Taxonomy Code: 103TC0700X

License # reported to NPPES OR 3292

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Oregon Medical Board.
Look Up on State Board Site

Secondary Practice Locations

10700 Sw Beaverton Hillsdale Hwy Ste 546

Beaverton, OR 970054739

Phone: 5034365663

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

19 Historical Events
πŸ“
Updated Practice Location November 06, 2023

Registered at 1975 NW 167TH PL STE 100-42, BEAVERTON, OR 970064908 (Tel: 5034365663)

πŸ“
Updated Business Mailing Address November 06, 2023

Registered at 1975 NW 167TH PL STE 100-42, BEAVERTON, OR 970064908 (Tel: 5034365663)

πŸ“
Updated Practice Location August 28, 2023

Registered at 10700 SW BEAVERTON HILLSDALE HWY STE 546, BEAVERTON, OR 970054739 (Tel: 5034365663)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 28, 2023

Psychologist

πŸ“
Updated Practice Location August 29, 2019

Registered at 14600 NW CORNELL RD, PORTLAND, OR 972295442 (Tel: 5036453581)

πŸ‘€
Provider Name / Credentials Updated August 29, 2019

Recorded as CHANEL DISMUKE, PSYD

πŸ“
Updated Practice Location August 13, 2018

Registered at 1015 MICHIGAN AVE, LOGANSPORT, IN 46947 (Tel: 5747225151)

πŸ‘€
Provider Name / Credentials Updated August 13, 2018

Recorded as CHANEL DISMUKE, MA

βœ…
NPI Profile Active October 12, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location October 12, 2017

Registered at 14600 NW CORNELL RD, PORTLAND, OR 972295442 (Tel: 5036453581)

πŸ“
Updated Business Mailing Address October 12, 2017

Registered at 14600 NW CORNELL ROAD, PORTLAND, OR 972295442

πŸ‘€
Provider Name / Credentials Updated October 12, 2017

Recorded as CHANEL DISMUKE

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 12, 2017

Counselor

βœ…
NPI Profile Active August 10, 2016

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) August 10, 2016

Registered at 222 SE 8TH AVE STE 212, HILLSBORO, OR 971234218 (Tel: 5033527333)

πŸ“
Business Mailing Address (Initial Record) August 10, 2016

Registered at 1816 23RD AVE, FOREST GROVE, OR 971161644 (Tel: 5033527333)

πŸ‘€
Provider Name / Credentials (Initial Record) August 10, 2016

Recorded as CHANEL DISMUKE

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 10, 2016

Counselor

🟒
Initial NPI Registration & Enumeration September 24, 2015

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1780053314
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 24, 2015
Last Update: July 04, 2024
Sole Proprietor: No

Mailing Address

1975 Nw 167th Pl Ste 100-42

Beaverton, OR 970064908

Phone: 5034365663

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.