| Positive Development For Youth And Families, Inc. | |
|
4531 Se Belmont St Ste 110 Portland OR 97215-1675 | |
| (503) 333-5213 | |
| (844) 774-3515 |
| Full Name | Positive Development For Youth And Families, Inc. |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 4531 Se Belmont St Ste 110, Portland, Oregon |
| Authorized Official Name and Position | Justin William Bush (CO-OWNER/LICENSED PSYCHLOGIST) |
| Authorized Official Contact | 5033335213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive Development For Youth And Families, Inc. 7616 N Leonard St Portland OR 97203-3231 Ph: (503) 333-5213 | Positive Development For Youth And Families, Inc. 4531 Se Belmont St Ste 110 Portland OR 97215-1675 Ph: (503) 333-5213 |
| NPI Number | 1912530643 |
|---|---|
| Provider Enumeration Date | 02/21/2020 |
| Last Update Date | 02/21/2020 |
| Certification Date | 02/21/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912530643 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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