Organization
COLLECTIVE CARE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL ASHLEY DAVIDSON PSY.D (PSYCHOLOGIST / OWNER)
(503) 313-0028
Entity
Organization
Contact information
Practice address
1130 SW MORRISON ST STE 619, PORTLAND, OR 97205-2217
(503) 313-0028
Mailing address
1130 SW MORRISON ST STE 619, PORTLAND, OR 97205-2217
(503) 313-0028
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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