Individual
ETHAN WARANCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
12636 SE STARK ST BLDG J, PORTLAND, OR 97233-1058
(503) 253-4600
(503) 253-4605
Mailing address
1411 SW MORRISON ST, SUITE 310, PORTLAND, OR 97205-1945
(503) 352-2400
(503) 352-2403
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3654
OR
Other
Enumeration date
07/16/2016
Last updated
02/02/2023
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