is a Prescribing (medical) in Portland, Oregon. practices all healthcare services and medical treatments related to Prescribing (medical). The NPI Number for is 1720298656. The last update date is .
's current location address is Po Box 25563, Portland, Oregon. You can contact this provider via phone number 5039165681 and fax number 5039162655. The mailing address for is Po Box 25563, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | Po Box 25563, Portland, Oregon |
| Phone Number | 5039165681 |
| Fax Number | 5039162655 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1720298656 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | Po Box 25563 |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972980563 |
| Phone Number | 5039165681 |
| Fax Number | 5039162655 |
Provider's Primary Taxonomy Detail
| Speciality | Prescribing (medical) |
|---|---|
| Taxonomy | 103Tp0016X |
| Licence No | 1252 |
|
Definition: A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establis |
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