| Judith Lynn Pulliam | |
|
4900 Sw Griffith Dr Ste 235 Beaverton OR 97005-4649 | |
| (503) 520-9977 | |
| (503) 526-3912 |
| Full Name | Judith Lynn Pulliam |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 4900 Sw Griffith Dr Ste 235, Beaverton, Oregon |
| Authorized Official Name and Position | Judith L Pulliam (PRACTITIONER) |
| Authorized Official Contact | 5039613562 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Judith Lynn Pulliam 4900 Sw Griffith Dr Ste 235 Beaverton OR 97005-4649 Ph: (503) 520-9977 | Judith Lynn Pulliam 4900 Sw Griffith Dr Ste 235 Beaverton OR 97005-4649 Ph: (503) 520-9977 |
| NPI Number | 1588211510 |
|---|---|
| Provider Enumeration Date | 08/23/2019 |
| Last Update Date | 10/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588211510 | NPI | - | NPPES |
| 1730208729 | Other | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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