Individual
MICHAEL IRVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
8440 SE SUNNYBROOK BLVD STE 120, CLACKAMAS, OR 97015-5781
(503) 653-0631
(503) 653-1464
Mailing address
8440 SE SUNNYBROOK BLVD STE 120, CLACKAMAS, OR 97015-5781
(503) 653-0631
(503) 653-1464
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2648
OR
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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