Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 825 | OR |
Y | 103TC0700X | Clinical Psychologist | 825 | OR |
NPI | 1003899337 |
---|---|
Provider Name | Dr. Sheryl Jane Chomak |
First Address | Beaverton, OR 97005-3019 |
Second Address | Beaverton, OR 97005-3019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2005 |
Last Update Date | 08/07/2007 |