Individual
WHITAKER L MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
1040 NW 22ND AVE STE 520, PORTLAND, OR 97210-3097
(503) 413-7557
Mailing address
4714 ROTHMAN PL, MONONA, WI 53716-2008
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OR
103T00000X
Psychologist
22082
WI
103T00000X
Psychologist
Primary
3288
OR
Other
Enumeration date
07/26/2018
Last updated
11/19/2024
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