Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 12246 | OR |
Y | 103TC0700X | Clinical Psychologist | 12246 | OR |
NPI | 1013084300 |
---|---|
Provider Name | Dr. Amy Susan Friday |
First Address | Beaverton, OR 97007 |
Second Address | Beaverton, OR 97007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 12/07/2013 |