Organization
INTERCULTURAL CENTER FOR PSYCHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGIY BARSUKOV PSYD (PSYCHOLOGIST)
(503) 930-2065
Entity
Organization
Contact information
Practice address
710C FOOTHILLS DR, SUITE 104, NEWBERG, OR 97132
(503) 930-2065
Mailing address
PO BOX 256, NEWBERG, OR 97132-0256
(503) 930-2065
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1935
OR
Other
Enumeration date
11/03/2011
Last updated
10/21/2020
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