Organization
SUNDSTROM CLINICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL LAZRINE (PRACTICE ADMINISTRATOR)
(503) 653-0631
Entity
Organization
Contact information
Practice address
21900 WILLAMETTE DR STE 202, WEST LINN, OR 97068-3284
(503) 653-0631
(503) 653-1464
Mailing address
21900 WILLAMETTE DR STE 202, WEST LINN, OR 97068-3284
(503) 653-0631
(503) 653-1464
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
01229457-2
OR
Other
Enumeration date
02/26/2007
Last updated
01/30/2018
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