Individual
CHARLES DAVID MAXEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
6950 SW HAMPTON ST STE 207, PORTLAND, OR 97223-8234
(503) 928-4182
Mailing address
6950 SW HAMPTON ST STE 207, PORTLAND, OR 97223-8234
(503) 928-4182
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
5067
OR
103TB0200X
Cognitive & Behavioral Psychologist
5067
OR
103TC0700X
Clinical Psychologist
5067
OR
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
5067
OR
Other
Enumeration date
12/25/2014
Last updated
07/18/2025
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