Individual
ERIKA V SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
847 NE 19TH AVE STE 150, PORTLAND, OR 97232-2686
(503) 222-0707
Mailing address
847 NE 19TH AVE STE 150, PORTLAND, OR 97232-2686
(035) 222-0707
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3705
OR
Other
Enumeration date
05/07/2018
Last updated
10/11/2023
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