Individual
DR. ALEX BLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
8285 SW NIMBUS AVE STE 130, BEAVERTON, OR 97008-6428
(503) 610-2044
(503) 296-2102
Mailing address
399 E 10TH AVE, EUGENE, OR 97401-3380
(541) 868-2004
(541) 868-2003
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2330
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
01
—
R0000WDBCH
MEDICARE GROUP
—
Enumeration date
12/16/2009
Last updated
05/20/2022
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