Healthcare Provider Details

I. General information

NPI: 1134024193
Provider Name (Legal Business Name): A.M. PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9620 NE TANASBOURNE DR STE 300
HILLSBORO OR
97124-7844
US

IV. Provider business mailing address

9620 NE TANASBOURNE DR STE 300
HILLSBORO OR
97124-7844
US

V. Phone/Fax

Practice location:
  • Phone: 503-874-6626
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALEXANDRIA MCCULLOCH
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 503-874-6626