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General NPI Number Information
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NPI Number | 1891838835
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Entity Type | Individual
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Provider Name | DAVID C WADE PSY D
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Gender | Male
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 05/22/2018
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Provider Practice Location Address
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Address Line | 1100 E MARINA WAY SUITE 221
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City | HOOD RIVER
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State | OR
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Zip | 97031-2305
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Country | US
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Telephone | 541-436-2998
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Fax | 541-436-2998
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Provider Business Mailing Address
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Address Line | 1100 E MARINA WAY STE 221
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City | HOOD RIVER
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State | OR
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Zip | 97031-2353
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Country | US
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Telephone | 509-493-1467
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Fax | 509-493-3765
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1081
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License Number State | OR
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