DR. KEN KORNELIS PH.D
NPI 1538360003
Psychologist - Clinical in Lake Oswego, OR

NPI Status: Active since May 30, 2007

Contact Information

15110 BOONES FERRY RD
STE 100E
LAKE OSWEGO, OR
ZIP 97035
Phone: (503) 538-6045
Fax: (503) 538-1598

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  • Individual
  • Male
  • Psychologist
  • Clinical
  • Accepts Insurance

About KEN KORNELIS

This page provides the complete NPI Profile along with additional information for Ken Kornelis, a provider established in Lake Oswego, Oregon with a medical specialization in Psychologist, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1538360003 assigned on May 2007. The practitioner's primary taxonomy code is 103TC0700X with license number 872 (OR). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI
1538360003
Provider Name
DR. KEN KORNELIS PH.D
Gender
Male
Entity Type
Individual
Location Address
15110 BOONES FERRY RD STE 100E LAKE OSWEGO, OR 97035
Location Phone
(503) 538-6045
Location Fax
(503) 538-1598
Mailing Address
15110 BOONES FERRY RD STE 100E LAKE OSWEGO, OR 97035
Mailing Phone
(503) 636-8654
Mailing Fax
(503) 538-1598
Is Sole Proprietor?
Yes
Enumeration Date
05-30-2007
Last Update Date
09-15-2017
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A clinical psychologist like Ken Kornelis assesses, diagnoses, and treats mental, emotional, and behavioral disorders. Clinical psychologists help people deal with problems ranging from short-term personal issues to severe, chronic conditions. Clinical psychologists interview patients, give diagnostic tests, provide psychotherapy and design behavior modification programs to help patients.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychologist Clinical

Taxonomy Code
103TC0700X
Type
Behavioral Health & Social Service Providers
License No.
872
License State
OR
Taxonomy Description
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BridgeSpan Standard Bronze Plan - EPO
  • BridgeSpan Standard Gold Plan - EPO
  • BridgeSpan Standard Silver Plan - EPO
  • Moda Health Affinity Bronze 7750 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Connect 1500 Gold - EPO
  • Connect 5000 Silver - EPO
  • Connect 9200 Bronze - EPO
  • HSA Qualified 7100 Bronze - Signature Network - EPO
  • HSA Qualified 7100 Bronze - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Bronze Essential 8500 With 4 Copay No Deductible Office Visits Individual and Family Network - EPO
  • Bronze HSA 7000 Individual and Family Network - EPO
  • Gold 2300 Individual and Family Network - EPO
  • Gold 2300 Legacy - EPO
  • Regence Standard Bronze Plan Individual and Family Network - EPO
  • Regence Standard Bronze Plan Legacy - EPO
  • Regence Standard Gold Plan Individual and Family Network - EPO
  • Regence Standard Gold Plan Legacy - EPO
  • Regence Standard Silver Plan Individual and Family Network - EPO
  • Regence Standard Silver Plan Legacy - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
101101MEDICARE ID-TYPE UNSPECIFIED (04)OR 

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1538360003
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
256866000
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 6 + 8 + 6 + 6 + 0 + 0 + 0 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1538360003 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 19 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1457305864DR. TANYA ELIZABETH HUDSON ND
Individual
Naturopath15110 BOONES FERRY RD 380
LAKE OSWEGO, OR 97035
(503) 547-7657
1700815909LOCC PATRICIA FINLEY PHD LLC
Organization
Psychologist (Clinical)15110 BOONES FERRY RD 220
LAKE OSWEGO, OR 97035
(503) 675-2830
1790864718DR. BARRY TRAVIS JONES PH.D.
Individual
Psychologist15110 BOONES FERRY RD STE. 350
LAKE OSWEGO, OR 97035
(503) 349-0810
1336277128DR. DOUGLAS RICHARD KUTNER PH.D.
Individual
Psychologist (Clinical)15110 BOONES FERRY RD SUITE 350
LAKE OSWEGO, OR 97035
(503) 730-2672
1801118195MS. DIANE LEONA ULICSNI C. HT
Individual
Specialist15110 BOONES FERRY RD SUITE 245
LAKE OSWEGO, OR 97035
(503) 699-6128
1346515509TANYA HUDSON, ND, LLC
Organization
Naturopath15110 BOONES FERRY RD STE 380
LAKE OSWEGO, OR 97035
(503) 547-7657
1396177895MISS SERENITY CELESTIA ACKLEY LMT
Individual
Massage Therapist15110 BOONES FERRY RD SUITE 100C
LAKE OSWEGO, OR 97035
(503) 422-9497
1437582780MRS. TABITHA RENEE THURSTON LMT
Individual
Massage Therapist15110 BOONES FERRY RD SUITE 100-C
LAKE OSWEGO, OR 97035
(503) 914-8803
1629490891DR. JESSICA M EVANS ND
Individual
Naturopath15110 BOONES FERRY RD STE 380
LAKE OSWEGO, OR 97035
(503) 675-2439
1942622402 VALENTYNA DINWIDDIE
Individual
Massage Therapist15110 BOONES FERRY RD 100-C
LAKE OSWEGO, OR 97035
(503) 547-7103
1316242324DR. SABRINA J. MARCUS DC
Individual
Chiropractor15110 BOONES FERRY RD SUITE 380
LAKE OSWEGO, OR 97035
(503) 974-9144
1801329008LAKE OSWEGO MASSAGE THERAPY
Organization
Massage Therapist15110 BOONES FERRY RD #220
LAKE OSWEGO, OR 97035
(503) 850-4810
1649791534 CORINNE CRISTINA LAZO
Individual
Massage Therapist15110 BOONES FERRY RD
LAKE OSWEGO, OR 97035
(503) 869-7470
1780190512 HANNA MARIA THOMPSON LMT
Individual
Massage Therapist15110 BOONES FERRY RD
LAKE OSWEGO, OR 97035
(503) 939-8016
1447750898 JENNIFER L NIEVES
Individual
Massage Therapist15110 BOONES FERRY RD
LAKE OSWEGO, OR 97035
(971) 238-7662
1487131058MRS. REBECCA ANN SNUGGS
Individual
Massage Therapist15110 BOONES FERRY RD
LAKE OSWEGO, OR 97035
(503) 939-8016
1306068424STEPHANI SHAVER LCSW LLC
Organization
Social Worker (Clinical)15110 BOONES FERRY RD #220
LAKE OSWEGO, OR 97035
(503) 675-2830
1841955069 SARA ALEXIS MILLER LAC
Individual
Acupuncturist15110 BOONES FERRY RD
LAKE OSWEGO, OR 97035
(503) 939-8016
1396025011MS. SAMANTHA O'BRIEN L.AC., LMT
Individual
Acupuncturist15110 BOONES FERRY RD 220
LAKE OSWEGO, OR 97035
(503) 381-9124

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1538360003, enumerated in the NPI registry as an "individual" on May 30, 2007

The provider is located at 15110 Boones Ferry Rd Ste 100e Lake Oswego, Or 97035 and the phone number is (503) 538-6045

The provider's speciality is Psychologist with taxonomy code 103TC0700X with a focus in Clinical

The provider might be accepting Accepts: BridgeSpan Health Company, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on May 30, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.