Organization
WESTERN PSYCHOLOGICAL AND COUNSELING SERVICES PC
Active
Organization
WESTERN PSYCHOLOGICAL AND COUNSELING SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA ROBERTSON (CONTRACT AND CREDENTIALING)
(503) 233-5405
Entity
Organization
Contact information
Practice address
22070 NE CHINOOK WAY, FAIRVIEW, OR 97024-2647
(971) 275-0294
Mailing address
22070 NE CHINOOK WAY, FAIRVIEW, OR 97024-2647
(971) 275-0294
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
LH 60489053
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000WDBCH-WA
—
WA
Enumeration date
11/26/2015
Last updated
01/26/2018
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