Individual
PHILLIP SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1110 SE ALDER ST STE 300, PORTLAND, OR 97214-2400
(203) 307-5238
Mailing address
1110 SE ALDER ST STE 300, PORTLAND, OR 97214-2400
(203) 307-5238
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
11410
MA
Other
Enumeration date
12/28/2020
Last updated
11/26/2024
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