Organization
BLOOM PSYCHOTHERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELISABETH P BLOOM PSYD (CLINICAL PSYCHOLOGIST)
(917) 727-0825
Entity
Organization
Contact information
Practice address
2330 NW FLANDERS ST STE 107, PORTLAND, OR 97210-3400
(917) 727-0825
Mailing address
2330 NW FLANDERS ST STE 107, PORTLAND, OR 97210-3400
(917) 727-0825
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/24/2020
Last updated
04/22/2024
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