Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Christopher Blaine Mikulic, PSYD

Individual provider Clinical Psychologist · NPI 1548759418

Christopher Blaine Mikulic, PSYD is a Clinical Psychologist in Lake Oswego, Oregon. Qualified in 2022, 4 years ago. Practices with Providence Health and Services Oregon, a 1,426-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
4
Licensed in
OR
In the registry since
2018
What do these letters mean?
PSYD — Doctor of Psychology
A doctoral psychologist trained primarily for clinical practice.

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Practice location Address checks out

4004 Kruse Way Pl Ste 300
Lake Oswego, OR 97035-2479
Phone: (503) 216-1500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 3693 (OR)

Record details

NPI number1548759418
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorNo
NPI enumeratedMay 7, 2018
Last updated in NPPESFebruary 2, 2024
Certification dateFebruary 2, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Providence Health And Services Oregon — 1426 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Lake Oswego