Provider Demographics
NPI:1013965425
Name:ADAMS, WENDI LYNN (PSYD)
Entity type:Individual
Prefix:DR
First Name:WENDI
Middle Name:LYNN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 SW 11TH AVE STE 914
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2123
Mailing Address - Country:US
Mailing Address - Phone:503-754-9676
Mailing Address - Fax:866-617-1750
Practice Address - Street 1:833 SW 11TH AVE STE 914
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2123
Practice Address - Country:US
Practice Address - Phone:503-754-9676
Practice Address - Fax:866-617-1750
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1618103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR273030Medicaid
ORR159355Medicare PIN
136772Medicare PIN