| Reverie Psychotherapy Llc | |
|
1500 Nw Bethany Blvd Ste 200 Beaverton OR 97006-5236 | |
| (503) 966-2395 | |
| Not Available |
| Full Name | Reverie Psychotherapy Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1500 Nw Bethany Blvd Ste 200, Beaverton, Oregon |
| Authorized Official Name and Position | Priscilla Shim (OWNER AND SOLE MEMBER) |
| Authorized Official Contact | 5039662395 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reverie Psychotherapy Llc 1500 Nw Bethany Blvd Ste 200 Beaverton OR 97006-5236 Ph: () - | Reverie Psychotherapy Llc 1500 Nw Bethany Blvd Ste 200 Beaverton OR 97006-5236 Ph: (503) 966-2395 |
| NPI Number | 1295453686 |
|---|---|
| Provider Enumeration Date | 08/22/2022 |
| Last Update Date | 08/22/2022 |
| Certification Date | 08/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295453686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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