GEROMEDICAL PSYCHOLOGICAL SERVICE PS

PORTLAND, OR
NPI1043501836
Entity TypeOrganization
Authorized ContactDERICK A SCOVEL
President
360-574-9565
Organization Subpart ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: OR  2074)
Enumeration Date2011-04-27
Last Update Date2020-09-17
Business Address
GEROMEDICAL PSYCHOLOGICAL SERVICE PS
3550 SW BOND AVE
PORTLAND, OR 97239-4507
Phone number: 360-574-9565
Mailing Address
GEROMEDICAL PSYCHOLOGICAL SERVICE PS
2400 MAIN ST
VANCOUVER, WA 98660-2663
Phone number: 360-574-9565