Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1556 | OR |
Y | 103TC0700X | Clinical Psychologist | 1556 | OR |
NPI | 1003982042 |
---|---|
Provider Name | Laurence W. Christensen |
First Address | Portland, OR 97210-2550 |
Second Address | Portland, OR 97210-2550 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |