MEDICARE: BARBARA G. ISAACS, PH.D.,PC

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	305S00000X	Point of Service	00786	OR

General Provider Information

NPI Number	:	1275707051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARBARA G. ISAACS, PH.D.,PC

Provider Business Mailing Address
First Line	:	5441 SW MACADAM AVENUE
Second Line	:	SUITE 102
City	:	PORTLAND
State	:	OR
Zip	:	97239-3821
Country	:	US
Telephone Number	:	503-248-0775
Fax Number	:	503-222-5480

Provider Business Practice Location Address
First Line	:	5441 SW MACADAM AVE
Second Line	:	SUITE 102
City	:	PORTLAND
State	:	OR
Zip	:	97239-6106
Country	:	US
Telephone Number	:	503-248-0775
Fax Number	:	503-222-5480

Authorized Official
Title or Position	:	CLINICAL PSYCHOLOGIST
Name	:	DR. BARBARA GAIL ISAACS
Credential	:	PH.D.PC
Telephone Number	:	503-248-0775

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	04/14/2008

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