Provider Demographics
NPI:1245450477
Name:CEGIELSKI, MALGOSIA ZOFIA (PHD)
Entity type:Individual
Prefix:MS
First Name:MALGOSIA
Middle Name:ZOFIA
Last Name:CEGIELSKI
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 1:8515 SW 61ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-3113
Mailing Address - Country:US
Mailing Address - Phone:503-236-3006
Mailing Address - Fax:503-236-3006
Practice Address - Street 1:8515 SW 61ST AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-3113
Practice Address - Country:US
Practice Address - Phone:503-236-3006
Practice Address - Fax:503-236-3006
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR870103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist