NPI 1083905996 · live from the CMS NPI Registry
Beaverton Psychology Services LLC
Psychologist in Beaverton, OR. National Provider Identifier 1083905996, active.
NPI record
| NPI | 1083905996 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist 103T00000X |
| Practice location | 16110 Sw Regatta Ln, Beaverton, OR 97006 |
| Practice phone | 503-526-2917 |
| Enumerated | April 26, 2011 |
| Last updated | December 23, 2020 |
| Authorized official | Terri Mishler, Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist primary | 103T00000X | 811 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.