Healthcare Provider Details

I. General information

NPI: 1952255663
Provider Name (Legal Business Name): UKANDU MENTAL HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2026
Last Update Date: 02/21/2026
Certification Date: 02/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 SW 1ST AVE
PORTLAND OR
97201-4707
US

IV. Provider business mailing address

3015 SW 1ST AVE
PORTLAND OR
97201-4707
US

V. Phone/Fax

Practice location:
  • Phone: 503-308-1196
  • Fax:
Mailing address:
  • Phone: 503-308-1196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOEL LAMPERT
Title or Position: CLINICAL DIRECTOR
Credential: PSY.D.
Phone: 503-577-6778