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Individual

DANIEL D CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
501 E 1ST ST, NEWBERG, OR 97132-2909
(503) 538-4874
(503) 538-1271
Mailing address
PO BOX 636, NEWBERG, OR 97132
(503) 538-4874
(503) 538-1271

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSYCHOLOGIST1508
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1508
PSYCHOLOGIST LICENSE NBR
OR
Enumeration date
09/09/2006
Last updated
02/14/2008
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