Healthcare Provider Details

I. General information

NPI: 1316001886
Provider Name (Legal Business Name): JOYCE A. KORSCHGEN, LPC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 NW 17TH AVE SUITE #3
PORTLAND OR
97209-2327
US

IV. Provider business mailing address

818 NW 17TH AVE SUITE #3
PORTLAND OR
97209-2327
US

V. Phone/Fax

Practice location:
  • Phone: 503-221-4531
  • Fax: 503-263-6278
Mailing address:
  • Phone: 503-221-4531
  • Fax: 503-263-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC0741
License Number StateOR

VIII. Authorized Official

Name: MS. JOYCE A. KORSCHGEN
Title or Position: PRESIDENT
Credential: LPC
Phone: 503-221-4531