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Organization
PORTLAND ANXIETY CLINIC
Active
Organization
PORTLAND ANXIETY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL DAVIDSON PSY.D. (PSYCHOLOGIST / OWNER)
(503) 313-0028
Entity
Organization
Contact information
Practice address
1130 SW MORRISON ST STE 619, PORTLAND, OR 97205-2217
(503) 313-0028
Mailing address
1130 SW MORRISON ST STE 619, PORTLAND, OR 97205-2217
(503) 313-0028
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2247
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841508553
JILL DAVIDSON NPI
OR
Enumeration date
09/07/2018
Last updated
09/07/2018
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