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1295870525
MYCO VAN
PORTLAND, OR
NPI
1295870525
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: OR 1791)
Enumeration Date
2007-02-21
Last Update Date
2009-11-07
Business Address
-- MYCO VAN Psy.D.
1500 NE IRVING ST SUITE 250
PORTLAND, OR 97232-2243
Phone number: 503-233-4356
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Mailing Address
-- MYCO VAN Psy.D.
8401 NE HALSEY ST STE 203
PORTLAND, OR 97220-5670
Phone number: 503-867-2289
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