Geromedical Psychological Services, Ps

NPI 1043501836 - Psychologist - 103TC0700X

NPI Details
NPI 1043501836
Enumeration Date 04/27/2011
Last Updated 06/10/2015
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name DERICK A DERICK
Position PRESIDENT
Phone (360) 574-9565
Fax (360) 574-9685
Practice Location
3550 SW BOND AVE
PORTLAND OR, 97239-4507, US
Phone (360) 574-9565
Fax (360) 574-9685
Business Location
10000 NE 7TH AVE
SUITE 215
VANCOUVER WA, 98685-4599, US
Phone (360) 574-9565
Fax (360) 574-9685
Toxanomy
Taxonomy Code 103TC0700X
License State Oregon
License Number 2074
Remove 1043501836 NPI Number
 

According to our database, Geromedical Psychological Services, Ps NPI is 1043501836, taxonomy code is 103TC0700X and license number is 2074, license state is located at Oregon. Geromedical Psychological Services, Ps physically located at 3550 Sw Bond Ave, Portland OR, 97239-4507. NPI Number 1033115704 has the healthcare provider type.

Sponsored links

1043501836 NPI number is provided on an as is basis without warranty of any kind. 1043501836 is maintained by the National Plan & Provider Enumeration System. The contents of Geromedical Psychological Services, Ps are for informational purposes only.