Provider Demographics
NPI:1295820389
Name:WEBB, NADIA E (PSYD, MPAP)
Entity Type:Individual
Prefix:MS
First Name:NADIA
Middle Name:E
Last Name:WEBB
Suffix:
Gender:F
Credentials:PSYD, MPAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1631 NE BROADWAY STR. #237
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232
Mailing Address - Country:US
Mailing Address - Phone:844-247-2422
Mailing Address - Fax:504-894-5115
Practice Address - Street 1:1631 NE BROADWAY STREET. NO. 237
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232
Practice Address - Country:US
Practice Address - Phone:844-247-2422
Practice Address - Fax:504-894-5115
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1087103G00000X
LA0012103TP0016X
NM1376103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)