SPORT PSYCHOLOGY INSTITUTE NORTHWEST
Agencies at 11 Ave, Portland, OR

License number
Oregon C1433
Category
Agencies
Type
Community/Behavioral Health
Owner
Name: MARK HENRY MA
Title: PRESIDENT
Phone: (866) 300-1515
Address
Address
833 SW 11Th Ave SUITE 925, Portland, OR 97205
National Provider ID: 1457667206
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about SPORT PSYCHOLOGY INSTITUTE NORTHWEST at bizstanding.com

SPORT PSYCHOLOGY INSTITUTE NORTHWEST, LLC

529 SW 3 Ave SUITE 525, Portland, OR 97204

Registration:
May 21, 2003
State ID:
14905293
Business type:
DOMESTIC LIMITED LIABILITY COMPANY
Agent:
Brian Baxter,529 SW 3 Ave SUITE 525, Portland, OR 97204 (Physical)

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