A Dragonfly Mind, LLC
Clinical Neuropsychologist in Portland, OR. Organization (NPI-2).
NPI number1730623729
StatusActive
Last updated in NPPESNov 8, 2021
Details
- NPI
- 1730623729
- Entity type
- Organization (NPI-2)
- Legal business name
- A Dragonfly Mind, LLC
- Organization subpart
- No
- Enumeration date
- Dec 9, 2016
- Certification date
- Nov 8, 2021
- Last updated
- Nov 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 071009422 | IL | Yes |
| 103G00000X | Clinical Neuropsychologist | 082604 | IA | |
| 103G00000X | Clinical Neuropsychologist | – | – |
Practice location
10260 Sw Greenburg Rd Ste 400Portland, OR 97223-5514
Phone 773-669-8378 · Fax 888-977-2162
Mailing address
2849 Sw Spring Garden StPortland, OR 97219-3984
Phone 217-369-1334 · Fax 888-977-2162
Other practice locations
1603 Orrington Ave Ste 600
Evanston, IL 60201-3860
Evanston, IL 60201-3860
Phone 773-669-8378 · Fax 888-977-2162
2005 Se 192nd Ave Ste 200
Camas, WA 98607-7475
Camas, WA 98607-7475
Phone 773-669-8378 · Fax 888-977-2162
Authorized official
Marcia R. Zumbahlen
Owner/Clinical Neuropsychologist
7736698378
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