Provider Demographics
NPI:1477534360
Name:AKOTS, NORMUND J (PHD, MS)
Entity Type:Individual
Prefix:DR
First Name:NORMUND
Middle Name:J
Last Name:AKOTS
Suffix:
Gender:M
Credentials:PHD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 SW EASTRIDGE ST.
Mailing Address - Street 2:STE 101
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-5064
Mailing Address - Country:US
Mailing Address - Phone:503-292-9183
Mailing Address - Fax:503-292-9280
Practice Address - Street 1:10200 SW EASTRIDGE ST.
Practice Address - Street 2:STE 101
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-5064
Practice Address - Country:US
Practice Address - Phone:503-292-9183
Practice Address - Fax:503-292-9280
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001545103TC0700X
OR1031103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR043427Medicaid
ORR118226Medicare PIN