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Organization
360 PEDIATRIC PSYCHOLOGY, PC
Active
Organization
360 PEDIATRIC PSYCHOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TABITHA SEREUA BECKER PSY. D (CLINICAL PSYCHOLOGIST COOWNER/PARTN)
(503) 720-9234
Entity
Organization
Contact information
Practice address
201 B AVE., SUITE #285, LAKE OSWEGO, OR 97034
(503) 636-0508
(503) 636-0387
Mailing address
201 B AVE., SUITE #285, LAKE OSWEGO, OR 97034
(503) 636-0508
(503) 636-0387
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
—
—
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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