Provider Demographics
NPI:1588784110
Name:GROUNDS, LINDA M (PHD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:GROUNDS
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 1:1130 SW MORRISON ST
Mailing Address - Street 2:SUITE #520
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2234
Mailing Address - Country:US
Mailing Address - Phone:503-242-9833
Mailing Address - Fax:503-242-0558
Practice Address - Street 1:1130 SW MORRISON ST
Practice Address - Street 2:SUITE #520
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2234
Practice Address - Country:US
Practice Address - Phone:503-242-9833
Practice Address - Fax:503-242-0558
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR721103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical