Provider Demographics
NPI:1972833424
Name:CHAMBERLIN, BETHANY L (PHD)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:L
Last Name:CHAMBERLIN
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 1:14255 SW BRIGADOON CT
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3369
Mailing Address - Country:US
Mailing Address - Phone:503-641-1475
Mailing Address - Fax:503-641-8548
Practice Address - Street 1:14255 SW BRIGADOON CT
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3369
Practice Address - Country:US
Practice Address - Phone:503-641-1475
Practice Address - Fax:503-641-8548
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health