Provider Demographics
NPI:1487963559
Name:HIGA, JUSTIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:HIGA
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 1:1130 SW MORRISON ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2234
Mailing Address - Country:US
Mailing Address - Phone:503-488-5470
Mailing Address - Fax:503-223-4846
Practice Address - Street 1:1130 SW MORRISON ST
Practice Address - Street 2:SUITE 250
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2234
Practice Address - Country:US
Practice Address - Phone:503-488-5470
Practice Address - Fax:503-223-4846
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-06
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2113103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical