| Embodied Psychotherapy Inc | |
|
3050 Se Division St Suite 210 Portland OR 97202-1451 | |
| (503) 577-2842 | |
| Not Available |
| Full Name | Embodied Psychotherapy Inc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 3050 Se Division St, Portland, Oregon |
| Authorized Official Name and Position | William Banjo Weymouth (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5035772842 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Embodied Psychotherapy Inc 3050 Se Division St Suite 210 Portland OR 97202-1451 Ph: (503) 577-2842 | Embodied Psychotherapy Inc 3050 Se Division St Suite 210 Portland OR 97202-1451 Ph: (503) 577-2842 |
| NPI Number | 1376963652 |
|---|---|
| Provider Enumeration Date | 04/24/2014 |
| Last Update Date | 04/24/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376963652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2135 (Oregon) | Primary |
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