Organization
OCTAVE BEHAVIORAL MICHIGAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYM EVERETT (VP, REVENUE OPERATIONS)
(650) 504-2289
Entity
Organization
Contact information
Practice address
1127 BROADWAY ST NE STE 310, SALEM, OR 97301-1143
(415) 360-3833
(628) 234-3048
Mailing address
625 MARKET ST FL 15, SAN FRANCISCO, CA 94105-3316
(650) 504-2289
(628) 234-3048
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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