Individual
DR. THOMAS JOSEPH DOHERTY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
5257 NE MARTIN LUTHER KING JR BLVD, SUITE 302, PORTLAND, OR 97211-3282
(503) 288-1213
(503) 296-5393
Mailing address
PO BOX 3174, PORTLAND, OR 97208-3174
(503) 288-1213
(503) 296-5393
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1628
OR
Other
Enumeration date
01/19/2007
Last updated
08/01/2008
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