Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1053775734 |
---|---|
Provider Name | Yasaman Ahmadi-Kashani |
First Address | Portland, OR 97225-6670 |
Second Address | Portland, OR 97225-6670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2016 |
Last Update Date | 26/08/2021 |