Organization
SEQUOIA COLLECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISSA BAZINET PHD (BUSINESS OWNER)
(503) 272-1713
Entity
Organization
Contact information
Practice address
5200 S MACADAM AVE, STE 460, PORTLAND, OR 97239-3836
(503) 272-1713
Mailing address
5200 S MACADAM AVE, STE 460, PORTLAND, OR 97239-3836
(503) 272-1713
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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