| Northwest Dbt Llc | |
|
2230 Nw Pettygrove St. Suite 130 Portland OR 97210 | |
| (503) 963-6540 | |
| (888) 965-8362 |
| Full Name | Northwest Dbt Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2230 Nw Pettygrove St., Portland, Oregon |
| Authorized Official Name and Position | Tracy Marie Jendritza (PROGRAM DIRECTOR) |
| Authorized Official Contact | 5039636540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Dbt Llc 2230 Nw Pettygrove St. Suite 130 Portland OR 97210 Ph: (503) 963-6540 | Northwest Dbt Llc 2230 Nw Pettygrove St. Suite 130 Portland OR 97210 Ph: (503) 963-6540 |
| NPI Number | 1215574058 |
|---|---|
| Provider Enumeration Date | 11/27/2019 |
| Last Update Date | 11/27/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215574058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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