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

Mary Bogle

Individual provider Clinical Psychologist · NPI 1083744536

Mary Bogle is a Clinical Psychologist in Portland, Oregon. Qualified in 2004, 22 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
22
Licensed in
CA
In the registry since
2007
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Practice location Address checks out

520 SW 6th Ave Ste 830
Portland, OR 97204-1514
Phone: (530) 917-8877
Fax: (530) 245-9222
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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 20469 (CA)

Record details

NPI number1083744536
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 6, 2007
Last updated in NPPESDecember 3, 2019

Medicare enrollment

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

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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