Individual
SAGE NOTTAGE SAXTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
707 SW GAINES ST, PORTLAND, OR 97239-2901
(503) 494-2672
Mailing address
707 SW GAINES STREET, PORTLAND, OR 97239
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1601
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275487
—
OR
Enumeration date
07/31/2006
Last updated
03/20/2008
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