Provider Demographics
NPI:1992826127
Name:PRESTON-ROYER, NANCY (MS ED)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:PRESTON-ROYER
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5331 SW MACADAM AVE STE 258
Mailing Address - Street 2:PMB 320
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3871
Mailing Address - Country:US
Mailing Address - Phone:503-901-6579
Mailing Address - Fax:
Practice Address - Street 1:9520 SW BEAVERTON HILLSDALE HWY
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3309
Practice Address - Country:US
Practice Address - Phone:503-901-6579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1973101YP2500X
CA41455106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist