Provider Demographics
NPI:1275612699
Name:WESTBROOK, BETH KAPLAN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:KAPLAN
Last Name:WESTBROOK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2250 NW FLANDERS ST
Mailing Address - Street 2:SUITE #105
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-3443
Mailing Address - Country:US
Mailing Address - Phone:503-222-4031
Mailing Address - Fax:503-222-4031
Practice Address - Street 1:2250 NW FLANDERS ST
Practice Address - Street 2:SUITE #105
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3443
Practice Address - Country:US
Practice Address - Phone:503-222-4031
Practice Address - Fax:503-222-4031
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1051103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR111891Medicare ID - Type Unspecified