Wendy June Bourg in Portland - Psychologist
Wendy June Bourg - NPI 1427276146
Wendy June Bourg is a Psychologist in Portland, Oregon. Wendy June Bourg practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Wendy June Bourg is 1427276146. The last update date is 2007-07-08.
Wendy June Bourg's current location address is 2701 Nw Vaughn St, Portland, Oregon. You can contact this provider via phone number 5039729806 and fax number 5032798926. The mailing address for Wendy June Bourg is 2701 Nw Vaughn St, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wendy June Bourg |
|---|---|
| Address | 2701 Nw Vaughn St, Portland, Oregon |
| Phone Number | 5039729806 |
| Fax Number | 5032798926 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1427276146 |
|---|---|
| Provider Enumeration Date | 2007-04-20 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2701 Nw Vaughn St |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972105311 |
| Phone Number | 5039729806 |
| Fax Number | 5032798926 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 1708 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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What is the unique identifier code issued to Wendy June Bourg by the Centers for Medicare & Medicaid Services?
The Wendy June Bourg has been assigned the NPI (National Provider Identifier) 1427276146. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Wendy June Bourg is physically located?
The Wendy June Bourg is physically situated at the following address: 2701 Nw Vaughn St, Portland, OR, 972105311.
What is Wendy June Bourg's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Wendy June Bourg is Psychologist, and the taxonomy code that categorizes this field of expertise is 103T00000X.
On what date did the Wendy June Bourg receive its 1427276146 assignment from the Centers for Medicare & Medicaid Services?
The Wendy June Bourg was assigned its 1427276146 by the Centers for Medicare & Medicaid Services on 2007-04-20.
As of what date were the details related to Wendy June Bourg most recently updated or revised?
The information pertaining to Wendy June Bourg, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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