Organization
WESTERN PSYCHOLOGICAL AND COUNSELING SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA ROBERTSON (CONTRACT AND CREDENTIALING)
(503) 233-5405
Entity
Organization
Contact information
Practice address
1700 NW CIVIC DR STE 310, GRESHAM, OR 97030-3774
(503) 666-8832
Mailing address
1700 NW CIVIC DR STE 310, GRESHAM, OR 97030-3774
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164936
—
OR
Enumeration date
02/13/2014
Last updated
01/26/2018
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