Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 406 | OR |
N | 103TC0700X | Clinical Psychologist | 406 | OR |
N | 103G00000X | Clinical Psychologist | 406 | OR |
N | 103TC0700X | Clinical Psychologist | 406 | OR |
N | 103TR0400X | Rehabilitation Psychologist | 406 | OR |
NPI | 1598981219 |
---|---|
Provider Name | Dr. Diane Kaye Pierce |
First Address | Portland, OR 97210-3025 |
Second Address | Portland, OR 97210-3025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
055103 | (05) | OR |
077404 | (05) | OR |
R94762 | (02) | OR |