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General NPI Number Information
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NPI Number | 1164042636
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Entity Type | Organization
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Legal Business Name | CYNTHIA POLANCE PSYCHOLOGY
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Dates
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Enumeration Date | 04/24/2020
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 7912 SW 35TH AVE STE 3
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City | PORTLAND
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State | OR
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Zip | 97219-2427
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Country | US
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Telephone | 503-278-4970
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Fax | 503-447-6640
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Provider Business Mailing Address
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Address Line | 8125 SW RUBY TER
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City | PORTLAND
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State | OR
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Zip | 97219-4649
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Country | US
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Telephone | 503-869-4040
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Fax | 503-447-6640
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA POLANCE
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Credential | PSYD
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Telephone | 503-869-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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