Organization
JUDITH LYNN PULLIAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH L PULLIAM LCSW (PRACTITIONER)
(503) 961-3562
Entity
Organization
Contact information
Practice address
4900 SW GRIFFITH DR STE 235, BEAVERTON, OR 97005-4649
(503) 520-9977
(503) 526-3912
Mailing address
4900 SW GRIFFITH DR STE 235, BEAVERTON, OR 97005-4649
(503) 520-9977
(503) 526-3912
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730208729
NPPES
—
Enumeration date
08/23/2019
Last updated
10/09/2019
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