Individual
SALLY J GILDEHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
16180 SE SUNNYSIDE RD STE 102, HAPPY VALLEY, OR 97015-6302
(503) 582-4900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
MC61175782
WA
103T00000X
Psychologist
Primary
PY61251520
WA
103TC0700X
Clinical Psychologist
3572
OR
Other
Enumeration date
04/24/2017
Last updated
09/04/2024
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