Constance Eldridge Pederson in Clackamas - Psychologist
Constance Eldridge Pederson - NPI 1548460637
Constance Eldridge Pederson is a Psychologist in Clackamas, Oregon. Constance Eldridge Pederson practices all healthcare services and medical treatments related to Psychologist. The NPI Number for Constance Eldridge Pederson is 1548460637. The last update date is 2021-11-30.
Constance Eldridge Pederson's current location address is 10117 Se Sunnyside Rd # F1217, Clackamas, Oregon. You can contact this provider via phone number 5037401971 and fax number 5032846051. The mailing address for Constance Eldridge Pederson is 10117 Se Sunnyside Rd # F1217, Clackamas, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Constance Eldridge Pederson |
|---|---|
| Address | 10117 Se Sunnyside Rd # F1217, Clackamas, Oregon |
| Phone Number | 5037401971 |
| Fax Number | 5032846051 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1548460637 |
|---|---|
| Provider Enumeration Date | 2007-07-18 |
| Last Updated Date | 2021-11-30 |
Provider Mailing Address Detail
| Address | 10117 Se Sunnyside Rd # F1217 |
|---|---|
| City | Clackamas |
| State | Oregon (OR) |
| Post Code | 970157708 |
| Phone Number | 5037401971 |
| Fax Number | 5032846051 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 1070 |
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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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 12322686 | OR | CAQH |
Post Comment/ Review Below
What is the unique identification code assigned to Constance Eldridge Pederson by the Centers for Medicare & Medicaid Services?
The Constance Eldridge Pederson has been issued the NPI (National Provider Identifier) 1548460637. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Constance Eldridge Pederson's facilities are geographically located?
The facilities of Constance Eldridge Pederson are physically situated at the following location: 10117 Se Sunnyside Rd # F1217, Clackamas, OR, 970157708.
What is Constance Eldridge Pederson's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Constance Eldridge Pederson's specialized field of practice is Psychologist, and the corresponding taxonomy code that categorizes this area of specialization is 103T00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1548460637 to Constance Eldridge Pederson?
The Constance Eldridge Pederson received its 1548460637 assignment from the Centers for Medicare & Medicaid Services on 2007-07-18.
When was the Constance Eldridge Pederson's information last updated?
The Constance Eldridge Pederson's information was last updated on 2021-11-30.
NPI Number: 1720081763
Address: 675 E Highway 60, Hardinsburg, KY