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Organization

JULIE EVANS BINGHAM PHD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JULIE EVANS BINGHAM PHD (LICENSED CLINICAL PSYCHOLOGIST)
(503) 584-9923
Entity
Organization

Contact information

Practice address
528 COTTAGE ST NE, SUITE 1D, SALEM, OR 97301-3811
(503) 584-9923
(503) 584-0303
Mailing address
528 COTTAGE ST NE, SUITE 1D, SALEM, OR 97301-3811
(503) 584-9923
(503) 584-0303

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1523
OR
2084P0800X
Psychiatry Physician
MD19881
OR
2084P0804X
Child & Adolescent Psychiatry Physician
MD19881
OR

Other

Enumeration date
11/01/2011
Last updated
09/05/2012
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