Individual
DR. SANDY M BUSHBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2230 OLD DALLES DR, HOOD RIVER, OR 97031-8533
(541) 380-0395
(541) 386-0078
Mailing address
2230 OLD DALLES DR, HOOD RIVER, OR 97031-8533
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1607
OR
103TB0200X
Cognitive & Behavioral Psychologist
Primary
1607
OR
103TC0700X
Clinical Psychologist
1607
OR
103TC2200X
Clinical Child & Adolescent Psychologist
1607
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218112
—
OR
Enumeration date
07/01/2008
Last updated
09/11/2009
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