MEDICARE: TODD RANSFORD PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1234	OR

General Provider Information

NPI Number	:	1134267842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD RANSFORD PH.D.

Provider Business Mailing Address
First Line	:	516 SE MORRISON ST
Second Line	:	SUITE 530
City	:	PORTLAND
State	:	OR
Zip	:	97214-2327
Country	:	US
Telephone Number	:	503-279-8160
Fax Number	:	503-239-0028

Provider Business Practice Location Address
First Line	:	516 SE MORRISON ST
Second Line	:	SUITE 530
City	:	PORTLAND
State	:	OR
Zip	:	97214-2327
Country	:	US
Telephone Number	:	503-279-8160
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/10/2007

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