Growth Endeavor Pc

NPI 1053594978 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1053594978
Enumeration Date 12/13/2007
Last Updated 07/31/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name SOPHA SOPHA
Position LICENSED CLINICAL PSYCHOLOGIST
Phone (503) 642-2086
Fax (508) 649-3628
Practice Location
6935 S.W. HALL BLVD
BEAVERTON OR, 97008, US
Phone (503) 642-2086
Fax (508) 649-3628
Business Location
6935 S.W. HALL BLVD
BEAVERTON OR, 97008, US
Phone (503) 642-2086
Fax (505) 649-3628
Toxanomy
Taxonomy Code 251S00000X
License State Oregon
License Number 1358
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According to our database, Growth Endeavor Pc NPI is 1053594978, taxonomy code is 251S00000X and license number is 1358, license state is located at Oregon. Growth Endeavor Pc physically located at 6935 S.w. Hall Blvd, Beaverton OR, 97008. NPI Number 1033115704 has the healthcare provider type.

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1053594978 NPI number is provided on an as is basis without warranty of any kind. 1053594978 is maintained by the National Plan & Provider Enumeration System. The contents of Growth Endeavor Pc are for informational purposes only.