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GEROMEDICAL PSYCHOLOGICAL SERVICE PS NPI 1043501836


NPI Information

NPI: 1043501836
Provider Name: GEROMEDICAL PSYCHOLOGICAL SERVICE PS
Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
3550 SW BOND AVE
PORTLAND, OR
ZIP 97239
Phone: (360) 574-9565
Get Directions

GEROMEDICAL PSYCHOLOGICAL SERVICE PS is a clinical psychologist in Portland, OR. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. GEROMEDICAL PSYCHOLOGICAL SERVICE PS NPI is 1043501836. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3550 SW BOND AVE
PORTLAND, OR
ZIP 97239-507
Phone: (360) 574-9565
Fax: (360) 574-9685

The provider's authorized official is Derick A Scovel .
The authorized official title is President and has the following contact phone number (360) 574-9565.

The enumeration date for this NPI number is 4/27/2011 and was last updated on 9/17/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinical2074OREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.