Organization
MARY BOGLE PSY D LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY BOGLE (CLINICAL PSYCHOLOGIST)
(503) 303-3740
Entity
Organization
Contact information
Practice address
11630 SE 40TH AVE STE A, MILWAUKIE, OR 97222-6195
(503) 303-3740
Mailing address
5111 SE LAKE RD, MILWAUKIE, OR 97222-4767
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
06/21/2022
Last updated
09/28/2023
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