Provider Demographics
NPI:1558429985
Name:ROBERTSON, WENDY JANE (MFT)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:JANE
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10956 SE AZAR DR
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-7804
Mailing Address - Country:US
Mailing Address - Phone:503-544-4832
Mailing Address - Fax:
Practice Address - Street 1:10956 SE AZAR DR
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-7804
Practice Address - Country:US
Practice Address - Phone:503-544-4832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0496106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist