| Transitions Professional Center | |
|
6514 Se 42nd Ave Portland OR 97206-7702 | |
| (503) 972-7090 | |
| (833) 527-3447 |
| Full Name | Transitions Professional Center |
|---|---|
| Speciality | Psychologist |
| Location | 6514 Se 42nd Ave, Portland, Oregon |
| Authorized Official Name and Position | Emily R Vierck (ADMINISTRATOR) |
| Authorized Official Contact | 5039727090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Transitions Professional Center 4207 Se Woodstock Blvd # 411 Portland OR 97206-6267 Ph: (503) 972-7090 | Transitions Professional Center 6514 Se 42nd Ave Portland OR 97206-7702 Ph: (503) 972-7090 |
| NPI Number | 1093126674 |
|---|---|
| Provider Enumeration Date | 05/16/2014 |
| Last Update Date | 05/15/2020 |
| Certification Date | 05/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093126674 | NPI | - | NPPES |
| 2439 | Other | OR | OREGON BOARD OF PSYCHOLOGIST EXAMINERS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2439 (Oregon) | Primary |
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