Provider Demographics
NPI:1790888659
Name:SIMS, JANET M (JANET SIMS)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:M
Last Name:SIMS
Suffix:
Gender:F
Credentials:JANET SIMS
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:M
Other - Last Name:SIMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1920 NW JOHNSON ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1325
Mailing Address - Country:US
Mailing Address - Phone:503-719-5499
Mailing Address - Fax:503-719-5499
Practice Address - Street 1:1920 NW JOHNSON ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1325
Practice Address - Country:US
Practice Address - Phone:503-719-5499
Practice Address - Fax:503-719-5499
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1978103TC0700X, 103TH0004X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral