Provider Demographics
NPI:1063550390
Name:OCHSNER, JOYCE M (PHD)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:M
Last Name:OCHSNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 NE HALSEY STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220
Mailing Address - Country:US
Mailing Address - Phone:503-539-9753
Mailing Address - Fax:503-254-5090
Practice Address - Street 1:8401 NE HALSEY STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220
Practice Address - Country:US
Practice Address - Phone:503-539-9753
Practice Address - Fax:503-254-5090
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1228103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR115331Medicare ID - Type UnspecifiedMEDICARE PART B PROVIDER