Organization
REVERIE PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCILLA SHIM PSYD (OWNER AND SOLE MEMBER)
(503) 966-2395
Entity
Organization
Contact information
Practice address
1500 NW BETHANY BLVD STE 200, BEAVERTON, OR 97006-5236
(503) 966-2395
Mailing address
1500 NW BETHANY BLVD STE 200, BEAVERTON, OR 97006-5236
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
08/22/2022
Last updated
08/22/2022
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