Healthcare Provider Details

I. General information

NPI: 1336211275
Provider Name (Legal Business Name): JOHN A TURNER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 US VETERANS HOSPITAL ROAD VA MEDICAL CENTER
PORTLAND OR
97202-9823
US

IV. Provider business mailing address

715 NW 96TH ST
VANCOUVER WA
98665-7535
US

V. Phone/Fax

Practice location:
  • Phone: 503-220-8262
  • Fax: 360-750-5385
Mailing address:
  • Phone: 360-696-4061
  • Fax: 360-750-5385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberPY00000579
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: