Individual
TAMARA PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2701 NW VAUGHN STREET, SUITE 360, PORTLAND, OR 97210
(503) 227-0671
(503) 227-0676
Mailing address
2701 NW VAUGHN STREET, SUITE 360, PORTLAND, OR 97210
(503) 227-0671
(503) 227-0676
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1995
OR
103TC0700X
Clinical Psychologist
801
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30423720
—
NH
Enumeration date
06/08/2006
Last updated
12/30/2016
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