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General NPI Number Information
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NPI Number | 1023549656
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Entity Type | Organization
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Legal Business Name | JASON DURTSCHI LCSW
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 3785 NW 2ND AVE
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City | HILLSBORO
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State | OR
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Zip | 97124-2156
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Country | US
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Telephone | 202-695-6958
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Fax |
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Provider Business Mailing Address
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Address Line | 3785 NW 2ND AVE
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City | HILLSBORO
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State | OR
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Zip | 97124-2156
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/OWNER
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Name | JASON DURTSCHI
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Credential | LCSW
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Telephone | 202-695-6958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | L6049
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License Number State | OR
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