NPI 1124187323
Children's Program
Practice location
- Address
- 7707 SW Capitol Hwy, Portland, OR 97219-2458
- Phone
- (503) 452-8002
Authorised official
- Name
- Mindy J Ranik
- Title
- Clinic Coordinator
- Phone
- (503) 452-8002
Registered specialties (5)
Developmental - Behavioral Pediatrics Physician
Primary
Professional Counselor
Clinical Psychologist
Clinical Child & Adolescent Psychologist
Child & Adolescent Psychiatry Physician
Registry record
- NPI
- 1124187323
- Entity type
- Organization
- NPI issued
- 6 Dec 2006
- Record last updated
- 11 Sep 2025
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.