Katie Ugolini Phd Llc | |
16110 Sw Regatta Ln Beaverton OR 97006-8942 | |
(503) 617-6810 | |
(503) 536-6794 |
Full Name | Katie Ugolini Phd Llc |
---|---|
Speciality | Clinic/Center |
Location | 16110 Sw Regatta Ln, Beaverton, Oregon |
Authorized Official Name and Position | Kathleen Anne Ugolini (OWNER) |
Authorized Official Contact | 5036176810 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Katie Ugolini Phd Llc 5620 Ne 25th Ave Portland OR 97211-6106 Ph: (503) 449-9690 | Katie Ugolini Phd Llc 16110 Sw Regatta Ln Beaverton OR 97006-8942 Ph: (503) 617-6810 |
NPI Number | 1164131603 |
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Provider Enumeration Date | 11/22/2022 |
Last Update Date | 11/22/2022 |
Certification Date | 11/22/2022 |
Medicare PECOS PAC ID | 1052782877 |
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Medicare Enrollment ID | O20230113001261 |
Identifier | Type | State | Issuer |
---|---|---|---|
1164131603 | NPI | - | NPPES |
1346267184 | Other | OR | INDIVIDUAL NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
Provider Name | Katie A Ugolini |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1346267184 PECOS PAC ID: 4981685252 Enrollment ID: I20040525000492 |
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