Individual
DR. MICHAEL MARCUS TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
880 82ND DR, GLADSTONE, OR 97027-1803
(503) 659-5515
(503) 659-1994
Mailing address
880 82ND DR, GLADSTONE, OR 97027-1803
(503) 659-5515
(503) 659-1994
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1216
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
10/18/2006
Last updated
07/09/2007
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