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Individual

NATHANIEL ISRAEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
7419 SE WOODSTOCK BLVD, PORTLAND, OR 97206-5838
(415) 271-9720
Mailing address
7419 SE WOODSTOCK BLVD, PORTLAND, OR 97206-5838
(415) 271-9720

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
31729
CA

Other

Enumeration date
05/05/2020
Last updated
05/05/2020
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