| Organization Name: | PSYCHOLOGICAL SERVICES CENTER, P.C. |
| NPI Number: | 1023408341 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TERRENCE WAGER (OWNER) |
| Mailing Address: | 1800 Blankenship Rd Ste 200 West Linn |
| State: | OR US |
| Postal Code: | 970684174 |
| Phone Number: | 9714005544 |
| Fax Number: | |
| NPI Enumeration Date: | 01/24/2015 |
| NPI Last Update Date: | 01/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 2220 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |