Organization
NORTHWEST DBT LLC
Active
Organization
NORTHWEST DBT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY MARIE JENDRITZA PSY.D. (PROGRAM DIRECTOR)
(503) 963-6540
Entity
Organization
Contact information
Practice address
2230 NW PETTYGROVE ST., SUITE 130, PORTLAND, OR 97210
(503) 963-6540
(888) 965-8362
Mailing address
2230 NW PETTYGROVE ST., SUITE 130, PORTLAND, OR 97210
(503) 963-6540
(888) 965-8362
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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