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Individual

DR. JAMES MATTHEW MOL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 571-6505
Mailing address
3210 NE SHAVER ST, PORTLAND, OR 97212-1747
(503) 284-1316

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
12706
CA
103T00000X
Psychologist
Primary
1423
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PSY12706031
CA
Enumeration date
02/18/2014
Last updated
12/29/2021
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