Provider Demographics
NPI:1265652309
Name:BOBOWICK, MICHELLE LYNN (DR)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LYNN
Last Name:BOBOWICK
Suffix:
Gender:F
Credentials:DR
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Mailing Address - Street 1:516 SE MORRISON ST #1010
Mailing Address - Street 2:CLEARWATER ASSOCIATES, LLC-MICHELLE BOBOWICK, PSY.D.
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-2340
Mailing Address - Country:US
Mailing Address - Phone:503-232-0992
Mailing Address - Fax:503-232-0791
Practice Address - Street 1:516 SE MORRISON ST STE 620
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-6305
Practice Address - Country:US
Practice Address - Phone:503-274-7855
Practice Address - Fax:503-230-7909
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR1528103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist