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Individual

CYNTHIA M POLANCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
7912 SW 35TH AVE STE 3, PORTLAND, OR 97219-2427
(503) 278-4970
(503) 447-6640
Mailing address
7912 SW 35TH AVE STE 3, PORTLAND, OR 97219-2427
(503) 278-4970
(503) 447-6640

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1997
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500770354
OR
Enumeration date
04/24/2009
Last updated
03/27/2020
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