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Organization
PORTLAND PSYCHOTHERAPY CLINIC
Active
Organization
PORTLAND PSYCHOTHERAPY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON LUOMA PH.D. (LICENSED PSYCHOLOGIST, PRESIDENT)
(503) 281-4852
Entity
Organization
Contact information
Practice address
3700 N WILLIAMS AVE, PORTLAND, OR 97227-1441
(503) 281-4852
Mailing address
3700 N WILLIAMS AVE, PORTLAND, OR 97227-1441
(503) 281-4852
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1661
OR
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/09/2007
Last updated
05/03/2017
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