Individual
DR. ALISSA DYAN BAZINET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5200 S MACADAM AVE, STE 460, PORTLAND, OR 97239-3836
(503) 272-1713
Mailing address
3737 SE 50TH AVE, PORTLAND, OR 97206-3024
(619) 203-8403
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2719
OR
Other
Enumeration date
07/24/2017
Last updated
03/31/2022
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