Provider Demographics
NPI:1194814665
Name:FRENCH, BETH DIANE (PSYD)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:DIANE
Last Name:FRENCH
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 1:831 NW COUNCIL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-3725
Mailing Address - Country:US
Mailing Address - Phone:503-258-4600
Mailing Address - Fax:
Practice Address - Street 1:831 NW COUNCIL DR STE 300
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-3725
Practice Address - Country:US
Practice Address - Phone:503-258-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1953103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR164936Medicaid
OROOOOWDBCHMedicare ID - Type Unspecified