Healthcare Provider Details

I. General information

NPI: 1609731280
Provider Name (Legal Business Name): BRENT FELNAGLE PSYCHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 SE MILWAUKIE AVE STE G
PORTLAND OR
97202-3835
US

IV. Provider business mailing address

10117 SE SUNNYSIDE RD STE F1182
CLACKAMAS OR
97015-7708
US

V. Phone/Fax

Practice location:
  • Phone: 503-479-8442
  • Fax:
Mailing address:
  • Phone: 503-479-8442
  • Fax: 971-266-4521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRENTON THOMAS FELNAGLE
Title or Position: OWNER/PSYCHOLOGIST
Credential: PSYD
Phone: 503-479-8442