Healthcare Provider Details

I. General information

NPI: 1134267842
Provider Name (Legal Business Name): TODD RANSFORD PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 SE MORRISON ST SUITE 530
PORTLAND OR
97214-2327
US

IV. Provider business mailing address

516 SE MORRISON ST SUITE 530
PORTLAND OR
97214-2327
US

V. Phone/Fax

Practice location:
  • Phone: 503-279-8160
  • Fax:
Mailing address:
  • Phone: 503-279-8160
  • Fax: 503-239-0028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1234
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: