GEROMEDICAL PSYCHOLOGICAL SERVICES, PS - NPI NUMBER 1043501836

Summary

Provider Name: GEROMEDICAL PSYCHOLOGICAL SERVICES, PS

NPI Number: 1043501836

NPI Type: Organization

Clasification: Psychologist (103TC0700X)

Specialization: Clinical

Address:
3550 SW BOND AVE
PORTLAND, OR
ZIP 97239

Phone Number: (360) 574-9565



Detailed Information

GEROMEDICAL PSYCHOLOGICAL SERVICES, PS is a clinical psychologist in Portland, OR. The assigned NPI number for this provider is 1043501836 and is registered as an organization entity type and is a single specialty group.

The provider's business 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 1/29/2014.

Map - Location of Practice




This page was last updated on: 4/19/2015

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.