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General NPI Number Information
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NPI Number | 1073853966
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Entity Type | Organization
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Legal Business Name | PORTLAND DBT INSTITUTE, INC.
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Dates
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Enumeration Date | 02/28/2013
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 5100 S MACADAM AVE., STE 350
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City | PORTLAND
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State | OR
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Zip | 97239-3877
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Country | US
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Telephone | 503-231-7854
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Fax | 503-231-8153
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Provider Business Mailing Address
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Address Line | 5100 S MACADAM AVE., STE. 350
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City | PORTLAND
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State | OR
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Zip | 97239-3837
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Country | US
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Telephone | 503-231-7854
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Fax | 503-231-8153
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Authorized Official
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Title or Position | BUSINESS OPERATIONS DIRECTOR
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Name | LOREN WAMPLER
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Credential |
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Telephone | 503-231-7854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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