Provider Demographics
NPI:1063039592
Name:CYTI PSYCHOLOGY LLC
Entity Type:Organization
Organization Name:CYTI PSYCHOLOGY LLC
Other - Org Name:CYTI PSYCHOLOGICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SUN JAE
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-625-0152
Mailing Address - Street 1:PO BOX 1310
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-1310
Mailing Address - Country:US
Mailing Address - Phone:808-772-3277
Mailing Address - Fax:
Practice Address - Street 1:12205 SW TUALATIN RD STE 270
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-7623
Practice Address - Country:US
Practice Address - Phone:503-625-0152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-30
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty