Provider Demographics
NPI:1073967766
Name:YOUNG, ASHLEIGH CAROLINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEIGH
Middle Name:CAROLINE
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 SE TENINO ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-6751
Mailing Address - Country:US
Mailing Address - Phone:503-683-3515
Mailing Address - Fax:
Practice Address - Street 1:1725 SE TENINO ST
Practice Address - Street 2:SUITE 203
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6751
Practice Address - Country:US
Practice Address - Phone:503-683-3515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2646103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical