| Older Growth Psychology | |
|
917 Sw Oak St Ste 218 Portland OR 97205-2805 | |
| (503) 227-3090 | |
| (971) 339-5269 |
| Full Name | Older Growth Psychology |
|---|---|
| Speciality | Psychologist |
| Location | 917 Sw Oak St Ste 218, Portland, Oregon |
| Authorized Official Name and Position | Marc Robert Parker (LICENSED PSYCHOLOGIST, OWNER) |
| Authorized Official Contact | 5032273090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Older Growth Psychology Po Box 83837 Portland OR 97283-0837 Ph: (503) 227-3090 | Older Growth Psychology 917 Sw Oak St Ste 218 Portland OR 97205-2805 Ph: (503) 227-3090 |
| NPI Number | 1578145884 |
|---|---|
| Provider Enumeration Date | 04/26/2021 |
| Last Update Date | 05/05/2021 |
| Certification Date | 05/05/2021 |
| Medicare PECOS PAC ID | 4587064704 |
|---|---|
| Medicare Enrollment ID | O20210609002965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578145884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Marc Robert Parker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629422175 PECOS PAC ID: 4486076544 Enrollment ID: I20210609003062 |
Sandra M. Gonzalez Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 Sw Morrison St, Suite 411, Portland, OR 97205 Phone: 503-228-0939 Fax: 503-226-8069 | |
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Wellpath Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 Se Milwaukie Ave Ste D, Portland, OR 97202 Phone: 503-784-2377 | |
Daniel C Donohue, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2931 Ne Broadway St, Portland, OR 97232 Phone: 503-819-2515 | |
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