Provider Demographics
NPI:1396246625
Name:BILINGUAL PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:BILINGUAL PSYCHOLOGICAL SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLEGAS-GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:503-702-7558
Mailing Address - Street 1:16117 WHITE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-4263
Mailing Address - Country:US
Mailing Address - Phone:503-702-7558
Mailing Address - Fax:
Practice Address - Street 1:516 SE MORRISON ST STE 221
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2342
Practice Address - Country:US
Practice Address - Phone:503-702-7558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BILINGUAL PSYCHOLOGICAL SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2027261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities