Provider Demographics
NPI:1497171102
Name:TRICIA A ZIGRANG LLC
Entity Type:Organization
Organization Name:TRICIA A ZIGRANG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZIGRANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:503-880-2320
Mailing Address - Street 1:1500 NW BETHANY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-5236
Mailing Address - Country:US
Mailing Address - Phone:541-819-0829
Mailing Address - Fax:503-662-6281
Practice Address - Street 1:1500 NW BETHANY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5236
Practice Address - Country:US
Practice Address - Phone:541-819-0829
Practice Address - Fax:503-662-6281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-06
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR469103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty