MEDICARE: TOMOKO GERSCH PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	97-04-82	OR

General Provider Information

NPI Number	:	1265673339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TOMOKO GERSCH PH.D.

Provider Business Mailing Address
First Line	:	171 SW COURT ST
Second Line	:
City	:	DALLAS
State	:	OR
Zip	:	97338-3112
Country	:	US
Telephone Number	:	503-831-1423
Fax Number	:	503-831-1573

Provider Business Practice Location Address
First Line	:	171 SW COURT ST
Second Line	:
City	:	DALLAS
State	:	OR
Zip	:	97338-3112
Country	:	US
Telephone Number	:	503-831-1423
Fax Number	:	503-831-1573

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2009
Last Update Date	:	03/18/2009

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Directions to “ TOMOKO GERSCH PH.D.” Practice Location

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