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
12636 SE STARK ST BLDG J, PORTLAND, OR 97233-1058
(503) 253-4600
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/28/2016
Last updated
01/26/2018
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