Individual
DR. HOWARD LAWRENCE DEITCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4850 SW SCHOLLS FERRY RD STE 107, PORTLAND, OR 97225-1691
(503) 296-5260
(503) 296-5261
Mailing address
4850 SW SCHOLLS FERRY RD STE 107, PORTLAND, OR 97225-1691
(503) 296-5260
(503) 296-5261
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0553
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101055
OMAP PROVIDER NUMBER
OR
Enumeration date
07/03/2006
Last updated
07/08/2007
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