Individual
DR. JUSTIN WILLIAM BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2100 NE BROADWAY, SUITE 101, PORTLAND, OR 97232-1569
(503) 287-2800
Mailing address
2100 NE BROADWAY, SUITE 101, PORTLAND, OR 97232-1569
(503) 287-2800
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2154
OR
Other
Enumeration date
12/22/2010
Last updated
02/26/2011
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