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

Jennifer R Antick, PHD

Individual provider Clinical Psychologist · NPI 1285626507

Jennifer R Antick, PHD is a Clinical Psychologist in Portland, Oregon. Qualified in 1995, 31 years ago. Practices with Legacy Good Samaritan Hospital and Medical Center, a 192-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Oregon and Washington.

Years since qualifying
31
Licensed in
OR, WA
In the registry since
2005
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

3181 SW Sam Jackson Park Rd Uhn 80
Portland, OR 97239-3011
Phone: (503) 494-7353
Fax: (503) 494-3282
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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 1853 (OR)
Clinical Psychologist Taxonomy 103TC0700X · Licence PY00002039 (WA)

Record details

NPI number1285626507
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorNo
NPI enumeratedAugust 22, 2005
Last updated in NPPESDecember 2, 2011

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1995 (31 years in practice)
Group practice Legacy Good Samaritan Hospital And Medical Center — 192 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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