Provider Demographics
NPI:1063632446
Name:MAJURI, CHARLES ERIC (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ERIC
Last Name:MAJURI
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 1:8414 SE 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-6908
Mailing Address - Country:US
Mailing Address - Phone:971-563-3103
Mailing Address - Fax:
Practice Address - Street 1:8414 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6908
Practice Address - Country:US
Practice Address - Phone:971-563-3103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA326752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health