Individual
DR. JAN M DEROEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
350 SW 30TH CT, TROUTDALE, OR 97060-3143
(503) 475-3274
Mailing address
350 SW 30TH CT, TROUTDALE, OR 97060-3143
(503) 475-3274
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1842
OR
103TC0700X
Clinical Psychologist
PY 00003927
WA
Other
Enumeration date
10/26/2007
Last updated
07/23/2009
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