Provider Demographics
NPI:1154515161
Name:GRIFFITH, SPENCER L (PSYD)
Entity type:Individual
Prefix:DR
First Name:SPENCER
Middle Name:L
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 NW BETHANY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-5236
Mailing Address - Country:US
Mailing Address - Phone:503-781-9085
Mailing Address - Fax:866-454-1261
Practice Address - Street 1:1500 NW BETHANY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5236
Practice Address - Country:US
Practice Address - Phone:503-781-9085
Practice Address - Fax:866-454-1261
Is Sole Proprietor?:No
Enumeration Date:2007-09-02
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1559103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical