Individual
AZIZ GAZIPURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1210 SE OAK ST, SUITE 1, PORTLAND, OR 97214-1427
(971) 998-3330
Mailing address
4310 SE WOODWARD ST, PORTLAND, OR 97206-2234
(971) 998-3330
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2230
OR
Other
Enumeration date
10/04/2011
Last updated
10/04/2011
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