Individual
DR. FORREST KUBLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1942 NW KEARNEY ST, STE 14, PORTLAND, OR 97209-1463
(503) 318-7736
(503) 287-4355
Mailing address
1942 NW KEARNEY ST, STE 14, PORTLAND, OR 97209-1463
(503) 318-7736
(503) 287-4355
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1660
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278037
—
OR
Enumeration date
07/13/2007
Last updated
03/21/2018
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