Jennifer R Antick is a Clinical in Portland, Oregon. Jennifer R Antick practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jennifer R Antick is 1285626507. The last update date is 2011-12-02.
Jennifer R Antick's current location address is 3181 Sw Sam Jackson Park Rd, Portland, Oregon. You can contact this provider via phone number 5034947353 and fax number 5034943282. The mailing address for Jennifer R Antick is 3181 Sw Sam Jackson Park Rd, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jennifer R Antick |
|---|---|
| Address | 3181 Sw Sam Jackson Park Rd, Portland, Oregon |
| Phone Number | 5034947353 |
| Fax Number | 5034943282 |
| Sole Proprietor | N |
| Credentials | PHD |
NPI Number Detail
| NPI Number | 1285626507 |
|---|---|
| Provider Enumeration Date | 2005-08-22 |
| Last Updated Date | 2011-12-02 |
Provider Mailing Address Detail
| Address | 3181 Sw Sam Jackson Park Rd |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972393011 |
| Phone Number | 5034947353 |
| Fax Number | 5034943282 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PY00002039 |
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Definition: 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 |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7099252 | WA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Jennifer R Antick by the Centers for Medicare & Medicaid Services?
The Jennifer R Antick has been assigned the NPI (National Provider Identifier) 1285626507 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please share the complete physical address where Jennifer R Antick is geographically located?
The Jennifer R Antick is physically situated at the following location: 3181 Sw Sam Jackson Park Rd, Portland, OR, 972393011.
What is Jennifer R Antick's area of expertise and its corresponding taxonomy classification?
The Jennifer R Antick's field of specialization is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services issue the 1285626507 to Jennifer R Antick?
The Jennifer R Antick received its 1285626507 assignment from the Centers for Medicare & Medicaid Services on 2005-08-22.
When was the Jennifer R Antick's information last updated?
The Jennifer R Antick's information was last updated on 2011-12-02.
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