Individual
DR. LILY A ITELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1509 SW SUNSET BLVD STE 1D, PORTLAND, OR 97239-2676
(503) 446-3435
Mailing address
1509 SW SUNSET BLVD STE 1D, PORTLAND, OR 97239-2676
(503) 446-3435
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
35143
TX
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
3431
OR
Other
Enumeration date
09/13/2011
Last updated
05/25/2024
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