NPI 1043501836

Geromedical Psychological Service Ps

Organisation Clinical Psychologist Portland, OR

Practice location

Address: 3550 SW Bond Ave, Portland, OR 97239-4507
Phone: (360) 574-9565
Fax: (360) 574-9685
Mailing address: 2400 Main St, Vancouver, WA 98660-2663

Authorised official

Name: Derick a Scovel
Title: President
Phone: (360) 574-9565

Registered specialties

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 2074 (OR)

Other Psychologist providers in Oregon →

Registry record

NPI: 1043501836
Entity type: Organization
NPI issued: 27 Apr 2011
Record last updated: 17 Sep 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.