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Organization

THERAPY PORTLAND CORPORATION PC

Active
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Organization

THERAPY PORTLAND CORPORATION PC

Active
Other names
Therapy Portland Corporation PC
Organization subpart
No

Provider details

NPI number
Authorized official
MYRA BAZELL LCSW (PSYCHOTHERAPIST)
(215) 917-3367
Entity
Organization

Contact information

Practice address
6635 N BALTIMORE AVE STE 282, PORTLAND, OR 97203-5462
(215) 917-3367
Mailing address
6635 N BALTIMORE AVE STE 282, PORTLAND, OR 97203-5462
(215) 917-3367

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—

Other

Enumeration date
08/06/2024
Last updated
09/10/2026
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