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General NPI Number Information
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NPI Number | 1588358600
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Entity Type | Organization
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Legal Business Name | MIDDLE WAY COUNSELING AND CONSULTATION SERVICES, LLC
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 9620 NE TANASBOURNE DR STE 300
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City | HILLSBORO
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State | OR
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Zip | 97124-7844
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Country | US
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Telephone | 971-236-6804
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Fax |
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Provider Business Mailing Address
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Address Line | 430 SE 32ND AVE
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City | HILLSBORO
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State | OR
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Zip | 97123-7008
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Country | US
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Telephone | 971-236-6804
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. VANESSA SOMOHANO
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Credential | PH.D., M.A.
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Telephone | 971-236-6804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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