Basic Information
| Provider Information | |||||||||
| NPI: | 1396246625 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BILINGUAL PSYCHOLOGICAL SERVICES | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BILINGUAL PSYCHOLOGICAL SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16117 WHITE OAKS DR | ||||||||
| Address2: | |||||||||
| City: | LAKE OSWEGO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970354263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5037027558 | ||||||||
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| Practice Location | |||||||||
| Address1: | 516 SE MORRISON ST STE 221 | ||||||||
| Address2: | |||||||||
| City: | PORTLAND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972142342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5037027558 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2018 | ||||||||
| LastUpdateDate: | 02/22/2018 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | VILLEGAS-GUTIERREZ | ||||||||
| AuthorizedOfficialFirstName: | MARTHA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | LICENSED PSYCHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 5037027558 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BILINGUAL PSYCHOLOGICAL SERVICES | ||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | PH.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QD1600X | 2027 | OR | Y | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
No ID Information.