Individual
LOREN E MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, ABPP
Contact information
Practice address
619 MADISON ST STE 108, OREGON CITY, OR 97045-2354
(503) 303-4257
(503) 387-3957
Mailing address
619 MADISON ST STE 108, OREGON CITY, OR 97045-2354
(503) 303-4257
(503) 387-3957
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
978
OR
103TC0700X
Clinical Psychologist
0978
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042544
—
OR
01
—
117227
MHN HMC
—
Enumeration date
01/08/2007
Last updated
04/09/2018
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