Provider Demographics
NPI:1295121291
Name:PHILLIPS, PHIL (LPC)
Entity type:Individual
Prefix:DR
First Name:PHIL
Middle Name:
Last Name:PHILLIPS
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32360 NW WASCOE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINS
Mailing Address - State:OR
Mailing Address - Zip Code:97133-8135
Mailing Address - Country:US
Mailing Address - Phone:253-661-7314
Mailing Address - Fax:
Practice Address - Street 1:8280 NE MAUZEY CT
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9092
Practice Address - Country:US
Practice Address - Phone:503-439-9531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60169539101Y00000X
ORC5976101Y00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor