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General NPI Number Information
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NPI Number | 1063505063
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Entity Type | Individual
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Provider Name | DAVID WINDSTROM PSY D
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 12/11/2013
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Provider Practice Location Address
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Address Line | 6950 SW HAMPTON ST STE. 218
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City | TIGARD
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State | OR
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Zip | 97223-8329
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Country | US
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Telephone | 503-972-8957
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Fax |
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Provider Business Mailing Address
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Address Line | 9220 SW BARBUR BLVD STE 119-241
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City | PORTLAND
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State | OR
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Zip | 97219-5428
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Country | US
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Telephone | 503-972-8957
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1702
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License Number State | OR
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