Provider Demographics
NPI:1033323241
Name:CHRISTENSEN, JOHN F (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:CHRISTENSEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2282 NW NORTHRUP ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2919
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2282 NW NORTHRUP ST
Practice Address - Street 2:SUITE 14
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2919
Practice Address - Country:US
Practice Address - Phone:503-413-7544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR497103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical