Individual
TANA PAGET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1962 NW KEARNEY ST STE 202, PORTLAND, OR 97209-1464
(503) 975-6984
Mailing address
1962 NW KEARNEY ST STE 202, PORTLAND, OR 97209-1464
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1480
OR
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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