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DR. DIANE KAYE PIERCE PH.D.

Clinical Neuropsychologist

Portland, Oregon

Provider NPI: 1598981219

Provider Information:
DR. DIANE KAYE PIERCE PH.D.
Gender: F
Sole Proprietor


Practice Location:
1015 NW 22ND AVE RIO 5-EAST PORTLAND, OR 97210 US
Tel: 503-413-6296  Fax: 503-413-8103

Business Mailing Address:
1015 NW 22ND AVE RIO 5-EAST PORTLAND, OR 97210 US
Tel: 503-413-6296  Fax: 503-413-8103

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
OR406
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
OR406
X103TR0400XBehavioral Health & Social Service Providers
Psychologist
OR406

Other Provider Identifiers:

IssuerNumberStateType
055103OR05
077404OR05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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