Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Forrest Kublick, PSYD

Individual provider Clinical Psychologist · NPI 1043419609

Dr. Forrest Kublick, PSYD is a Clinical Psychologist in Portland, Oregon. Qualified in 2003, 23 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
23
Licensed in
OR
In the registry since
2007
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

1942 NW Kearney St Ste 14
Portland, OR 97209-1463
Phone: (503) 318-7736
Fax: (503) 287-4355
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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 1660 (OR)

Record details

NPI number1043419609
Entity typeIndividual (Type 1)
GenderMale
Credentials PSYD
Sole proprietorYes
NPI enumeratedJuly 13, 2007
Last updated in NPPESMarch 21, 2018

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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