Organization
OREGON TRUAMA CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TEREK KANSO PSY.D. LPC (THERAPIST)
(503) 866-9688
Entity
Organization
Contact information
Practice address
5 CENTERPOINTE DR STE 400, LAKE OSWEGO, OR 97035-8661
(503) 866-9688
Mailing address
10127 SW 59TH PL, PORTLAND, OR 97219-5708
(503) 866-9688
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
C4721
OR
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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