Provider Demographics
NPI:1164596813
Name:BOYD, JOSHUA JAMES (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:JAMES
Last Name:BOYD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 WINTER ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-2428
Mailing Address - Country:US
Mailing Address - Phone:503-507-5877
Mailing Address - Fax:503-585-4552
Practice Address - Street 1:627 WINTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-2428
Practice Address - Country:US
Practice Address - Phone:503-507-5877
Practice Address - Fax:503-585-4552
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1814103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical