Organization
WESTERN PSYCHOLOGICAL AND COUNSELING SERVICES PC
Active
Organization
WESTERN PSYCHOLOGICAL AND COUNSELING SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA ROBERTSON (CONTRACT AND CREDENTIALING)
(503) 233-5405
Entity
Organization
Contact information
Practice address
890 SE 82ND, GLADSTONE, OR 97027
(503) 659-5515
Mailing address
PO BOX 82819, PORTLAND, OR 97282
(503) 233-5405
(503) 233-2694
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
10/29/2014
Last updated
01/26/2018
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