Provider Demographics
NPI:1831314541
Name:LUAHNA UDE, PHD, PC
Entity Type:Organization
Organization Name:LUAHNA UDE, PHD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUAHNA
Authorized Official - Middle Name:C
Authorized Official - Last Name:UDE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:503-222-5010
Mailing Address - Street 1:1133 NW 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-1513
Mailing Address - Country:US
Mailing Address - Phone:503-222-5010
Mailing Address - Fax:
Practice Address - Street 1:1133 NW 21ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1513
Practice Address - Country:US
Practice Address - Phone:503-222-5010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0393103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty