Provider Demographics
NPI:1518019066
Name:TERHAAR, VIRGINIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:VIRGINIA
Middle Name:
Last Name:TERHAAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:834 SW SAINT CLAIR AVE
Mailing Address - Street 2:#206
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-1322
Mailing Address - Country:US
Mailing Address - Phone:503-274-1945
Mailing Address - Fax:
Practice Address - Street 1:834 SW SAINT CLAIR AVE
Practice Address - Street 2:#206
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1322
Practice Address - Country:US
Practice Address - Phone:503-274-1945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0044101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional