Individual
TABITHA BECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 B AVE, SUITE 285, LAKE OSWEGO, OR 97034-3159
(503) 636-0508
(503) 636-0387
Mailing address
201 B AVE, SUITE 285, LAKE OSWEGO, OR 97034-3159
(503) 636-0508
(503) 636-0387
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
2484
OR
103TC0700X
Clinical Psychologist
2484
OR
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2484
OR
103TH0004X
Health Psychologist
2484
OR
103TM1800X
Intellectual & Developmental Disabilities Psychologist
2484
OR
Other
Enumeration date
09/30/2014
Last updated
09/30/2014
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