Provider Demographics
NPI:1669597530
Name:MOVING BOUNDARIES, INC
Entity type:Organization
Organization Name:MOVING BOUNDARIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRKHART
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:503-661-4126
Mailing Address - Street 1:1375 SW BLAINE CT
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97080-5383
Mailing Address - Country:US
Mailing Address - Phone:503-661-4126
Mailing Address - Fax:503-661-5304
Practice Address - Street 1:1375 SW BLAINE CT
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97080-5383
Practice Address - Country:US
Practice Address - Phone:503-661-4126
Practice Address - Fax:503-661-5304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1082103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty