Healthcare Provider Details

I. General information

NPI: 1548454465
Provider Name (Legal Business Name): GEORGE A HOWARD PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CENTERPOINTE DR STE 400
LAKE OSWEGO OR
97035-8661
US

IV. Provider business mailing address

16869 SW 65TH AVE # 388
LAKE OSWEGO OR
97035-7865
US

V. Phone/Fax

Practice location:
  • Phone: 503-201-8958
  • Fax: 971-223-7133
Mailing address:
  • Phone: 503-272-6239
  • Fax: 971-223-7133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number1245
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number1245
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1245
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1245
License Number StateOR
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number1245
License Number StateOR
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License Number1245
License Number StateOR
# 7
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number1245
License Number StateOR
# 8
Primary TaxonomyN
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number1245
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: