Individual
DR. JOAN ELLEN AUSUBEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
317 SW ALDER ST, SUITE 1140, PORTLAND, OR 97204-2547
(503) 294-2111
(503) 525-0752
Mailing address
8205 SE 11TH AVE, PORTLAND, OR 97202-6535
(503) 232-6153
(503) 232-6157
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
735
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
735
PSYCHOLOGIST LICENSE #
OR
Enumeration date
04/24/2007
Last updated
07/09/2007
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