Chanel Breae Dismuke, PSYD
NPI 1780053314ActiveIndividual· Psychologist· Beaverton, OR
Psychologist (PSYD) in Beaverton, Oregon, licensed in OR, with an NPI issued in September 2015.
Overview
| NPI | 1780053314 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PSYD |
| Sole proprietor | No |
| NPI issued | Sep 24, 2015 |
| Last updated in NPPES | Jul 4, 2024 |
| Certified by provider | Jul 4, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | 3292 | OR |
| Psychologist, Cognitive & Behavioral | 103TB0200X | — | — |
| Psychologist, Clinical | 103TC0700X | 3292 | OR |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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