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PAUL EDWARD GUASTADISEGNI PH.D.

Clinical Neuropsychologist

Portland, Oregon

Provider NPI: 1356460901

Provider Information:
 PAUL EDWARD GUASTADISEGNI PH.D.
Gender: M
Sole Proprietor


Practice Location:
511 SW 10TH AVE SUITE 1115 PORTLAND, OR 97205 US
Tel: 503-223-7766  Fax: 503-223-8844

Business Mailing Address:
511 SW 10TH AVE SUITE 1115 PORTLAND, OR 97205 US
Tel: 503-223-7766  Fax: 503-223-8844

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
OR1307
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
OR1307
X103TC2200XBehavioral Health & Social Service Providers
Psychologist
OR1307
X103TF0200XBehavioral Health & Social Service Providers
Psychologist
OR1307
X103TM1800XBehavioral Health & Social Service Providers
Psychologist
OR1307

Other Provider Identifiers:

IssuerNumberStateType
159027OR05
OREGON VENDOR NUMBERM39331OR01
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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