Individual
DR. SUSANNAH BOCK CASTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
5200 SW MACADAM AVE, SUITE 580, PORTLAND, OR 97239-6103
(503) 970-2942
Mailing address
5200 SW MACADAM AVE, SUITE 580, PORTLAND, OR 97239-6103
(503) 970-2942
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1825
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245831
—
OR
Enumeration date
07/20/2007
Last updated
06/06/2008
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