NPI 1619112018 · live from the CMS NPI Registry
Winston Anderson, Psy.D.
Psychologist, Clinical in Portland, OR. National Provider Identifier 1619112018, active.
NPI record
| NPI | 1619112018 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 1500 Ne Irving St, Suite 250, Portland, OR 97232 |
| Practice phone | 503-258-4200 |
| Mailing address | 4207 Ne 32nd Ave, Portland, OR 97211 |
| Enumerated | December 13, 2008 |
| Last updated | December 13, 2008 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | 1751 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.