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General NPI Number Information
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NPI Number | 1720206055
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Entity Type | Organization
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Legal Business Name | JANICE I. VOLKIN
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 5520 SW MACADAM AVE #260
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City | PORTLAND
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State | OR
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Zip | 97239-3768
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Country | US
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Telephone | 503-705-1032
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Fax | 503-741-2006
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Provider Business Mailing Address
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Address Line | 5520 SW MACADAM AVE #260
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City | PORTLAND
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State | OR
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Zip | 97239-3741
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Country | US
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Telephone | 503-705-1032
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Fax | 503-741-2006
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Authorized Official
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Title or Position | OWNER
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Name | DR. JANICE I. VOLKIN
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Credential | PH.D.
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Telephone | 503-705-1032
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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 | 829
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License Number State | OR
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